Lecture 12 Myeloma and Paraproteins

Question 1

What is the most prevalent antibody

Answer 1

IgG

Question 2

What antibody provides mucous membrane immunity

Answer 2

IgA

Question 3

What is a paraprotein

Answer 3

A monoclonal immunoglobulin present in blood or urine

Question 4

If a paraprotein is present what does this tell us?

Answer 4

It tells us that there is monoclonal proliferation of a B lymphocyte/plasma cell in the body

Question 5

IgM paraproteins would suggest what disease

Answer 5

Lymphoma

Question 6

IgG and IgA paraproteins would suggest what disease

Answer 6

Myeloma

Question 7

What is Myeloma

Answer 7

Neoplastic disorder of the plasma cells resulting in excessive production of a single immunoglonulin (paraprotein)

Question 8

What are the clinical features of Myeloma

Answer 8

Peaks in 7th decade
Commoner in black ethnicities 
Bone disease
Bone marrow failure (anaemia)
Infections
–	CRAB – hypercalcaemia, renal failure, anaemia, bone disease

Question 9

Whats the effect of paraprotein on kidneys

Answer 9

Renal failure- immunoglobulin deposition and blockage of renal tubes

Question 10

What is the effect of paraprotein on the blood

Answer 10

Hyperviscosity

Question 11

What is the effect of paraproteins on immunoglobulin production

Answer 11

Impairs production

Question 12

What is an additional effect of paraproteins

Answer 12

Amyloidosis

Question 13

How is myeloma treated

Answer 13

Proteasome inhibitors (chemo)
Bisphosphonate therapy
Radiotherapy
Steroids 
Autologous SCT