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, 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
- Serum and urine protein electrophoresis:
- Screening test for Waldenström macroglobulinemia [2]
- Detection of M spike
- Serum and urine immunofixation
- Confirmatory test for waldenström's macroglobulinemia[2]
- 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
- ↑ 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.
- ↑ 2.0 2.1 Waldenström macroglobulinaemia. American Cancer Society (2015) http://www.cancer.org/cancer/waldenstrommacroglobulinemia/detailedguide/waldenstrom-macroglobulinemia-diagnosis Accessed on November 15th, 2015