Plasma cell disorder- P Flashcards
What is multiple myeloma?
Malignant proliferation of plasma cells in the BM
What is the significance of multiple myeloma?
IT is the most common primary malignancy of bone
- however most common malignancy lesion of bone overall is the Metastatic cancer
What would be high in the serum with someone who had multiple myeloma?
IL-6
- stimulates plasma cell growth and immunoglobulin production
What are the clinical features of multiple myeloma?
- bone pain with hypercalcemia
- elevated serum protein
- Increased risk of infection
- Rouleaux formation of RBC
- Primary AL amyloidosis
- Proteinuria
What is the cause of bone pain and hypercalcemia in multiple myeloma?
Neoplastic plasma cells secrete Osteoclast activating Factor which binds to RANK receptor on osteoclasts and stimulates them
- leading to lytic lesions (vertebra and skull)
Why would one have elevated serum protein in multiple myeloma?
- Neoplastic plasma cell produce immunoglobulin
- leads to an M spike on Serum protein electrophoresis
- most commonly IgG and sometimes IgA
How does one with multiple myeloma have increased risk for infection?
Monoclonal proliferation lacks Antigenic diversity
- infection is the MOST common cause of death in multiple myeloma
What cause the RBC’s for form Rouleaux in multiple myeloma?
Increased serum protein decreases charge on RBC’s thus they start to stack on top of one another
What cause Primary AL amyloidosis in multiple myeloma?
Free light chains circulate in serum and deposit in tissue
-due to overproduction
What cause proteinuria in multiple myeloma?
Free light chains are excreted in the urine as Bence Jones proteins
- can lead to deposition in kidney tubules and leads to risk of renal failure
What is renal failure called in multiple myeloma?
Myeloma kidney
What is Monoclonal Gammopathy of Undetermined significance (MGUS)?
Increased serum protein with an M spike on SPEP however lacks: - lytic bone lesions -hypercal -AL amyloid -Bence jones proteinuria
Who commonly gets MGUS and what can it turn into?
Elderly - 5% of plp over 70
1% chance of multiple myeloma each year
What is Waldenstrom Macroglobulinemia?
B cell lymphoma with monoclonal IgM production
What are the clinical features of Waldenstrom macroglobulinemia?
- LAD no lytic bone lesions
- Increased Serum protein with M spike (IgM
- Visual and neuro deficits
- Bleeding
