Waldenström's macroglobulinemia laboratory findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mirdula Sharma, MBBS [2]
Overview
Elevated Beta-2-microglobulin and abnormal coagulation studies are diagnostic of Waldenström's macroglobulinemia. [1]
Laboratory Findings
Complete blood count
- Normocytic normochromic anemia: presents in 80% of patients[1]
- Leukopenia
- Thrombocytopenia: presents in 50% of patients with bleeding diathesis
Peripheral smear
- Plasmacytoid lymphocytes
- Normocytic normochromic red blood cells
- Rouleaux formation
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.
- Coaglulation 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.
- Patients start presenting with hyperviscosity symptoms when viscosity >4 centipoise.
References
- ↑ 1.0 1.1 García-Sanz R, Montoto S, Torrequebrada A, de Coca AG, Petit J, Sureda A, Rodríguez-García JA, Massó P, Pérez-Aliaga A, Monteagudo MD, Navarro I, Moreno G, Toledo C, Alonso A, Besses C, Besalduch J, Jarque I, Salama P, Rivas JA, Navarro B, Bladé J, Miguel JF (2001). "Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases". Br. J. Haematol. 115 (3): 575–82. PMID 11736938.