Waldenström's macroglobulinemia laboratory findings: Difference between revisions
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===Complete blood count=== | ===Complete blood count=== | ||
* | *Anemia | ||
*[[Thrombocytopenia]] | **Seen in 40% of newly diagnosed patients and in 80% of symptomatic patients with Waldenström's macroglobulinemia. | ||
**The cause of anemia in Waldenström's macroglobulinemia is multifactorial: | |||
***Decreased RBC synthesis due to bone marrow infiltration | |||
***Iron deficiency due to gastrointestinal bleeding | |||
***Chronic inflammation | |||
*[[Thrombocytopenia]] | |||
** | |||
*Neutropenia | *Neutropenia | ||
*Lymphocytosis | |||
*Monocytosis | |||
===Peripheral smear=== | ===Peripheral smear=== | ||
Revision as of 00:58, 31 October 2018
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Waldenström's macroglobulinemia Microchapters |
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Differentiating Waldenström's macroglobulinemia from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mirdula Sharma, MBBS [2]Roukoz A. Karam, M.D.[3]
Overview
Laboratory findings consistent with the diagnosis of Waldenström's macroglobulinemia include any cytopenia, elevated LDH, and elevated Beta-2 microglobulin.
Laboratory Findings
Complete blood count
- Anemia
- Seen in 40% of newly diagnosed patients and in 80% of symptomatic patients with Waldenström's macroglobulinemia.
- The cause of anemia in Waldenström's macroglobulinemia is multifactorial:
- Decreased RBC synthesis due to bone marrow infiltration
- Iron deficiency due to gastrointestinal bleeding
- Chronic inflammation
- Thrombocytopenia
- Neutropenia
- Lymphocytosis
- Monocytosis
Peripheral smear
- Plasmacytoid lymphocytes
- Normocytic normochromic red blood cells
- Rouleaux formation
Serum and urine protein electrophoresis
- Screening test for Waldenström macroglobulinemia [1]
- Detection of M spike
Serum and urine immunofixation
- Confirmatory test for waldenström's macroglobulinemia[1]
- Determines the IgM type of immunoglobulin
Chemistry lab tests
- Elevated beta-2-microglobulin in proportion to tumor mass
- Elevated lactate dehydrogenase
- Elevated creatinine
- Electrolyte abnormalities:
- Hypercalcemia(4%)
- Elevated erythrocyte sedimentation rate and uric acid
- Total protein levels
- Albumin-to-globulin ratio
- Rheumatoid factor, cryoglobulins, direct anti-globulin test, and cold agglutinin titre results can be positive.
- Coagulation studies can be abnormal with elevated prothrombin time, activated partial thromboplastin time, and thrombin time.
Plasma viscosity
- Plasma viscosity should be measured in patients presenting with hyperviscosity syndrome whenever the monoclonal IgM protein spike is >4 g/dL.
- The normal plasma viscosity is 1.8 centipoise.
- Patient presents with hyperviscosity symptoms with viscosity >4 centipoise.
References
- ↑ 1.0 1.1 Waldenström macroglobulinaemia. American Cancer Society (2015) http://www.cancer.org/cancer/waldenstrommacroglobulinemia/detailedguide/waldenstrom-macroglobulinemia-diagnosis Accessed on November 15th, 2015