Plasma cell disorders (dyscrasias) Flashcards
Which cell proliferates in multiple myeloma?
plasma cells in the bone marrow
What may be found in the serum of someone with multiple myeloma?
IL6 which stimulates plasma cell growth and immunoglobulin production
Clinical features of multiple myeloma
Bone pain with hypercalcemia Elevated serum protein Increased risk of infection Rouleaux formation Primary AL amyloidosis Proteinuria
Pathophys of bone pain in multiple myeloma?
the neoplastic plasma cells activate RNK receptor on osteoclasts –> bone destruction, punched out bone lesions, increased risk of fracture
What will you see on XRAY of someone with multiple myeloma?
punched out lesions of bone
What will you see on serum electrophoresis of someone with multiple myeloma and why?
M spike -represents monoclonal IgG or igA produced by neoplastic plasma cells
Why will someone with multiple myeloma have increased risk of susceptibility to infection?
Monoclonal antibody production lacks antigenic diversity
What will you see on blood smear of someone with multiple myeloma and why?
Rouleaux formation of RBCs - increased protein that decreases charge of RBCs
Why may someone have primary AL amyloidosis in multiple myeloma?
free light chains circulate in serum and deposit in tissue
What effect will multiple myeloma potentially have on the kidney?
free light chains excreted in urine as benze jones protein may deposit in tubules and lead to risk of renal faliure
Explain monoclonal gammopathy of undetermined significant (MGUS)
increased serum protein with M spike without other features of multiple myeloma
Who is the common population to get MGUS
elderly
complication of MGUS
May progress to multiple myeloma
What will you see on electrophoresis of MGUS?
M spike
What is over produced in Waldenstrom macroglobulinemia?
igM
