Myeloma and paraproteins Flashcards
What is the main producer of B cells?
B cells - plasma cells
Primary role of antibodies
recognise and bind pathogens
antibodies - how many heavy and light chains?
2 of both
5 types of Ig heavy chain
IgG IgM IgA IgE IgD
What is the most prevalent antibody subclass?
IgG
2 types of light chains
kappa
lambda
Paraprotein
monoclonal immunoglobulin present in blood or urine
If paraprotein is present what does this tell us?
monoclonal proliferation of B lymphocyte/plasma cell
Serum protein electrophoresis
separates protein based on size and charge
bands of different widths and intensities based on proteins present
4 tests
total Ig levels
electrophoresis
immunofixation
light chains
Aim of immuofixation
identify what class of paraprotein present
IgM paraproteins =
lymphoma
IgG, IgA paraproteins
myeloma
myeloma
neoplastic disorder of plasma cells resulting in paraprotein
when does myeloma peak?
7th decade
Myeloma features
bone disease - lytic lesions pathological fractures spinal cord compression hypercalcaemia bone marrow failure - anaemia infections
effects of the paraprotein
renal failure - cast nephropathy hyperviscosity syndrome = bleeding hypogammaglobulinaemia amyloidosis nephrotic syndrome, carpal tunnel
How is myeloma diagnosed?
excess plasma cells in bone marrow
>10% of total bone marrow cell population
stage of myeloma based on…
albumin
beta 2 macroglobulin
myeloma treatment
chemotherapy bisphosphonate - zoledronic acid radiotherapy steroids surgery autologous stem cell transplant
Does IgM myeloma exist?
NO - lymphoma
