Waldenström's macroglobulinemia laboratory findings: Difference between revisions

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==Laboratory Findings==
==Laboratory Findings==
Laboratory findings consistent with the diagnosis of [disease name] include:
* '''Complete blood count''':


===Complete blood count===
**Anemia
*Anemia
***Seen in 40% of newly diagnosed patients and in 80% of symptomatic patients with Waldenström's macroglobulinemia
**Seen in 40% of newly diagnosed patients and in 80% of symptomatic patients with Waldenström's macroglobulinemia.
***Multifactorial causes including: decreased RBC synthesis due to bone marrow infiltration, iron deficiency due to gastrointestinal bleeding, chronic inflammation.
**The cause of anemia in Waldenström's macroglobulinemia is multifactorial:
**[[Thrombocytopenia]]
***Decreased RBC synthesis due to bone marrow infiltration
***Due to bone marrow infiltration
***Iron deficiency due to gastrointestinal bleeding
****
***Chronic inflammation
**Neutropenia
*[[Thrombocytopenia]]
***Due to bone marrow infiltration
**
**Lymphocytosis
*Neutropenia
**Monocytosis
*Lymphocytosis
*Monocytosis


===Peripheral smear===
* '''Peripheral smear''':
*Plasmacytoid lymphocytes
*Normocytic normochromic red blood cells
*[[Rouleaux]] formation


===Serum and urine protein electrophoresis===
**Plasmacytoid lymphocytes
*Screening test for Waldenström macroglobulinemia <ref name="qwer">Waldenström macroglobulinaemia. American Cancer Society (2015) http://www.cancer.org/cancer/waldenstrommacroglobulinemia/detailedguide/waldenstrom-macroglobulinemia-diagnosis Accessed on November 15th, 2015 </ref>
**Normocytic normochromic red blood cells
*Detection of M spike
**[[Rouleaux]] formation


===Serum and urine immunofixation===
* '''Serum and urine protein electrophoresis:'''
*Confirmatory test for waldenström's macroglobulinemia<ref name="qwer">Waldenström macroglobulinaemia. American Cancer Society (2015) http://www.cancer.org/cancer/waldenstrommacroglobulinemia/detailedguide/waldenstrom-macroglobulinemia-diagnosis Accessed on November 15th, 2015 </ref>


*Determines the IgM type of immunoglobulin
**Screening test for Waldenström macroglobulinemia <ref name="qwer">Waldenström macroglobulinaemia. American Cancer Society (2015) http://www.cancer.org/cancer/waldenstrommacroglobulinemia/detailedguide/waldenstrom-macroglobulinemia-diagnosis Accessed on November 15th, 2015 </ref>
**Detection of M spike


===Chemistry lab tests===
* '''Serum and urine immunofixation'''
*Elevated [[beta-2-microglobulin]] in proportion to tumor mass
 
*Elevated [[lactate dehydrogenase]]
**Confirmatory test for waldenström's macroglobulinemia<ref name="qwer">Waldenström macroglobulinaemia. American Cancer Society (2015) http://www.cancer.org/cancer/waldenstrommacroglobulinemia/detailedguide/waldenstrom-macroglobulinemia-diagnosis Accessed on November 15th, 2015 </ref>
*Elevated [[creatinine]]
 
*Electrolyte abnormalities:
**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%)
:*[[Hypercalcemia]](4%)
*Elevated [[erythrocyte sedimentation rate]] and [[uric acid]]
**Elevated [[erythrocyte sedimentation rate]] and [[uric acid]]
*Total protein levels
**Total protein levels
*[[Albumin-to-globulin ratio]]
**[[Albumin-to-globulin ratio]]
*[[Rheumatoid factor]], [[cryoglobulins]], direct anti-globulin test, and cold agglutinin titre results can be positive.  
**[[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]].
**[[Coagulation studies]] can be abnormal with elevated [[prothrombin time]], [[activated partial thromboplastin time]], and [[thrombin time]].
 
* '''Plasma viscosity'''


===Plasma viscosity===
**Plasma viscosity should be measured in patients presenting with [[hyperviscosity syndrome]] whenever the monoclonal IgM protein spike is >4 g/dL.
*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.  
*The normal plasma viscosity is 1.8 centipoise.  
**Patient presents with hyperviscosity symptoms with viscosity >4 centipoise.
*Patient presents with hyperviscosity symptoms with viscosity >4 centipoise.


==References==
==References==

Revision as of 01:50, 31 October 2018

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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

Laboratory findings consistent with the diagnosis of [disease name] include:

  • Complete blood count:
    • Anemia
      • Seen in 40% of newly diagnosed patients and in 80% of symptomatic patients with Waldenström's macroglobulinemia
      • Multifactorial causes including: decreased RBC synthesis due to bone marrow infiltration, iron deficiency due to gastrointestinal bleeding, chronic inflammation.
    • Thrombocytopenia
      • Due to bone marrow infiltration
    • Neutropenia
      • Due to bone marrow infiltration
    • 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
  • 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. ↑ 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

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