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: Roukoz A. Karam, M.D.[2] Mirdula Sharma, MBBS [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 Waldenström macroglobulinemia include:[1]
- 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, and chronic inflammation.
- Thrombocytopenia
- Due to bone marrow infiltration
- Due to bone marrow infiltration
- Neutropenia
- Due to bone marrow infiltration
- Lymphocytosis
- Monocytosis
- Anemia
- Peripheral smear:
- Plasmacytoid lymphocytes
- Normocytic normochromic red blood cells
- Rouleaux formation
- Chemistry Lab tests:[2]
- Elevated lactate dehydrogenase (LDH)
- Level indicates the extent of the disease
- Elevated creatinine
- Rarely
- Electrolyte abnormalities:
- Elevated erythrocyte sedimentation rate (ESR) and uric acid
- Rheumatoid factor, cryoglobulins, direct anti-globulin test, and cold agglutinin titre results can be positive
- Elevated beta-2-microglobulin in proportion to tumor mass
- Needed to evaluate prognosis
- Elevated lactate dehydrogenase (LDH)
- Platelet function test and blood coagulation studies:
- Prolonged bleeding time[3]
- Possibly due to interaction between platelet membrane glycoproteins and IgM paraprotein
- Abnormalities in prothrombin time, activated partial thromboplastin time, thrombin time, and fibrinogen
- Prolonged bleeding time[3]
References
- ↑ García-Sanz R, Montoto S, Torrequebrada A, de Coca AG, Petit J, Sureda A; et al. (2001). "Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases". Br J Haematol. 115 (3): 575–82. PMID 11736938.
- ↑ Katzmann JA, Kyle RA, Benson J, Larson DR, Snyder MR, Lust JA; et al. (2009). "Screening panels for detection of monoclonal gammopathies". Clin Chem. 55 (8): 1517–22. doi:10.1373/clinchem.2009.126664. PMC 3773468. PMID 19520758.
- ↑ Penny R, Castaldi PA, Whitsed HM (1971). "Inflammation and haemostasis in paraproteinaemias". Br J Haematol. 20 (1): 35–44. PMID 4924493.