Glossary of 9. Abnormal Immunoglobulin Production
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- How many possible types of immunoglobulins are there?
What are they?
- 10: IgGkappa, IgGlambda, so forth for G, A,M,E,D
- How many types of Ig can individual plasma cells produce?
- ONLY ONE.
- How to plasma cells normally respond to antigen?
- What is Monoclonal Gammopathy?
- An increase in serum of ONE specific Ig molecule/fragment.
- What diseases present with monoclonal gammopathy?
- 1. Multiple myeloma (plsma cell)
2. Waldenstroms Macroglobulinem.
4.Benign monoclonal gammopathy
- What 3 methods are used to detect monoclonal gammopathy?
- 1. Serum protein electrophores.
3. Serum/urine Ig determinations
- What are the 3 types of Monoclonal gammopathies we learn about?
- 1.Plasma cell myeloma (Multiple)
2. Waldenstroms Macroglobulinem.
3. Heavy Chain disease
- What's the major problem with multiple myeloma?
- MANY BODY SYSTEMS are involved.
- What patient popln gets Multiple myeloma?
- Older - rarely under 40.
- What is the most common symptom of plasma cell myeloma?
- Pathologic bone breaks - when picking up a bag of groceries or something.
- In multiple myeloma, what are the lab findings w/ respect to:
RBC, WBC, Platelets, CAlcium, ESR, protein?
- RBC: n/n anemia w/ ROULEAUX
Plt: normto decreased
Ca+: lots in the blood/urine
- What special type of proteins cause the proteinuria in Multiple myeloma?
- BENCE JONES proteins - excess light chains excreted.
- What is the usually elevated protein in Mult. myeloma?
2nd most common?
- IgM - causes an M spike on electrophoresis.
- What bone marrow abnormality shows up w/ plasma cell myeloma?
- POCKETS of plasma cells.
- What causes the bone breaks?
- OAF - osteoclast activating factor - causes increased bone resorption, stimulated by abnormal plasma cells.
- What is Waldenstrom's Macroglobulinemia?
- A plasma cell dyscrasia that is possibly a varient of CLL or WDLL
- What patients usually get Waldenstrom's MAcroglobulinemia?
- Older than 40
- What are general physical, visible symptoms of Waldo's macroglob?
- General Lymphadenopathy
- Why the splenomegaly?
- Hyperviscous blood from high protein content - causes visual and neurological problms.
- What 3 chronic lymphoma diseases can have accompan. splenomegal?
- 1. Hairy cell
- What 2 plasma cell dyscrasias can have assoc. rouleaux?
- 1. Multiple Myeloma
- What are the Lab findings in Waldo's macroglob?
-Anemia, WBCs, ESR,
- -N/N anemia w/ thrombocytopenia and pancytopenia
-MARKED ROULEAUX, incr. ESR
- What does the bone marrow look like in Waldo's macroglob?
- Infiltrated by lymphs, plasmacytoid lymphs, and plasma cells.
- What does Ig electrophoresis show in Waldo's macroglob?
- Elevated serum Ig - only M (mu) chain and only one type of light chain (kappa or lambda).
- Which plasma cell dyscrasia sees pockets of plasma cells in BM?
- only multiple myeloma.
- What are Heavy Chain Diseases?
- Uncommon gammopathies where only one single heavy chain is present, no light chain.
- What are the 3 types of Heavy chain disease?
- 1. Gamma
- What type of disease is Gamma heavy chain most similar to?
How is it diagnosed?
- Malignant lymphoma (instead of myeloma)
- What patients usually get Alpha heavy chain disease?
What are distinguishing features?
- Younger - malabsorption and diarrhea; massive infiltration of intestines w/ lympocytes and plasma cells.
- What is the least common heavy chain disease?
- IgM - Mu heavy chain disease.
-Identified by IEP, vaculated plasma cells in the BM.
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