myeloma Flashcards
what is it?
malignant plasma cell dyscrasia (bad mixture)
what is it characterised by?
proliferation of abnormal plasma cells in the bone marrow
what do the plasma cells secrete?
monoclonal antibodies
what does the secretion of monoclonal antibodies and the reduction of functional antibodies lead to?
relative hypogammaglobinaemia
what does myeloma lead to?
bone destruction
kidney dysfunction
anaemia
and systemic symptoms
what are the risk factors?
genetics
exposure to radiation or certain chemicals
immunosuppressive conditions
what are the clinical features?
CRAB HAI
hyperCalcaemia - moans, stones and stomach groans
Renal impairment
Anaemia - thrombocytopenia and leukopenia
Bone pathology - back pain very common - pathological fractures
Hyperviscosity - headache, visual disturbance and thrombosis
Amyloidosis - cardiac failure and neuropathy
Infection - recurrent infections
what can myeloma cause?
paraproteinemiaw
what is paraproteinemia?
disproportionate proliferation of immunoglobulin cells (B-cells)
what are some other causes of paraproteinemia?
MGUS
AL amyloidosis
Waldenstrom’s macroglobinaemia
what are the features of MGUS?
paraprotein <30g/L
bone marrow plasma cells <10%
no evidence of myeloma end organ damage (normal calcium and renal function)
what are features of myeloma (again)?
back pain - multiple lytic bone lesions in spine -> wedge compression fracture in thoracic vertebrae
hypercalcaemia - stones, bones and groans
kidney impairment - light chain deposition -> cast nephropathy
bence-jones proteins (clonal light chains)
what staining is used for AL amyloidosis?
congo red staining
what are the features of Waldenstrom’s macroglobinaemia?
IgM paraprotein -> lymphadenopathy, splenomegaly, neuropathy, hyperviscosity
