multiple myeloma Flashcards
definition
clinical proliferation of plasma cells most commonly IgG secreting
plasma cells are
white blood cells which are normally responsible for producing antibodies
in multiple myeloma
the haematopoeitc stem cells shifts production to produce more plasma cells so there are greater than 10% plasma cells in the bone marrow
The plasma cells secrete abnormal antibodies and light chains (paraproteins), main antibodies produces §are IgG and IgA
what cells normally regulate haematopoesis
bone marrow stroll cells
in multiple myeloma the bone marrow stromal cells
adhere to the multiple myeloma cells resulting in cytokine mediated cells growth, survival, drug resistance, migration of the multiple myeloma cells
multiple myeloma cells reduce
the production of osteoblasts and increase the osteoclastic activity which causes lytic lesions and causes pathological fractures and hypercalcaemia
paraproteins produced can get
filtered by the glomerulus and cause renal failure, they can also enter the urine which is what is seen when bence jones protein is positive
what is the classic presentation of multiple myeloma
renal failure and back pain
signs of multiple myeloma
anaemia, hypercalcaemia, renal failure, amyloidosis, recurrent infections
symptoms of multiple myelomas
bone pain, weakness, fatigue and weight loss
pneumonic for remembering the symptoms of multiple myeloma
CRAB hyperCalcaemia Renal Failure Anaemia Bone pain
diagnosis of multiple myeloma: bloods
- serum protein electrophoresis shows high M protein levels
- serum free light chains
- anaemia
- hypercalcaemia
- uraemia
diagnosis of multiple myeloma: urine
hence jones protein
other diagnostic tests
- bone marrow biopsy ALWAYS shows plasma cells greater than 10%
- skeletal survey shows lytic bone lesions
- renal biopsy
what is highly associated with multiple myeloma
carpal tunnel syndrome
