Waldenström's macroglobulinemia laboratory findings

Waldenström's macroglobulinemia Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Waldenström's macroglobulinemia from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
Bone Marrow Aspiration and Biopsy
Electrophoresis and Immunofixation
Chest X Ray
CT
MRI
Echocardiography or Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Waldenström's macroglobulinemia laboratory findings On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Waldenström's macroglobulinemia laboratory findings All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Waldenström's macroglobulinemia laboratory findings
CDC on Waldenström's macroglobulinemia laboratory findings
Waldenström's macroglobulinemia laboratory findings in the news
Blogs on Waldenström's macroglobulinemia laboratory findings
Directions to Hospitals Treating Waldenström's macroglobulinemia
Risk calculators and risk factors for Waldenström's macroglobulinemia laboratory findings

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:

• 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
• Chemistry Lab tests:
  • Elevated lactate dehydrogenase (LDH)
    • Level indicates the extent of the disease
  • Elevated creatinine
    • Rarely
  • Electrolyte abnormalities:
    • Hypercalcemia
    • Hyponatremia
  • 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
• Platelet function test and blood coagulation studies:
  • Prolonged bleeding time
    • Possibly due to interaction between platelet surface glycoproteins and IgM paraprotein
  • Abnormalities in prothrombin time, activated partial thromboplastin time, thrombin time, and fibrinogen
• 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.