Paraproteinemia
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Paraproteinemia

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    Paraproteinemia Paraproteinemia Presentation Transcript

    • Paraproteinemia John Matthews
    • Definition of a paraprotein
      • A monoclonal immunoglobulin or immunoglobulin light chain in the blood or urine resulting from a clonal proliferation of plasma cells or B-lymphocytes (synonyms: M-band, monoclonal band, monoclonal spike, monoclonal protein)
    • Identification of paraproteins
      • Serum protein electrophoresis
      • Immunofixation
      • Urine protein electrophoresis
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    • Three major disorders associated with paraproteinemia
      • Monoclonal Gammopathy of Undetermined Significance (MGUS)
      • Multiple Myeloma
      • Waldenströms Macroglobulinemia
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      • Incidence
        • 3-6/100,000
        • mean age 60: M=F: Black:White 2:1
      • Cause
        • Unknown (?radiation)
      • Presentation
        • Bone pain 60% Anemia 15% Renal 10% Chance 10% Other 5%.
      • Diagnosis
        • 2 of (a) paraprotein (b) bone lesions (c) plasma cells in BM
      Multiple Myeloma
    • Multiple Myeloma - therapy
      • Attack the neoplasm (chemo  ASCT)
      • Preserve the bones (bisphosphonate)
      • Treat problems: (bones, anemia, infection, renal failure, bleeding, hyperviscosity)
      • Prognosis: incurable: overall median survival 30 months
    • Multiple Myeloma and the Kidney
      • Obstruction of tubules by light chains
      • Tubule-cell damage by light chain
      • Light chain deposition
      • Amyloidosis
      • Hypercalcemia
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