Laboratory features
The hallmark of Waldenstrom's macroglobulinaemia is the presence of a monoclonal IgM spike on serum protein electrophoresis in the beta or gamma globulin region.
Other features:
- increased serum viscosity
- anaemia - usually normochromic, normocytic; occasionally haemolytic
- raised ESR
- marked rouleaux formation; +ve Coomb's test
- bone marrow sections - hypercellular; infiltrated by the plasmocytic lymphocytes which are also present on peripheral blood
- Bence Jones proteinuria in at least 10% of cases
- x-rays should be normal; renal failure is unusual
- IgM may cause cryoglobulinaemia
Reference
- Pratt G, El-Sharkawi D, Kothari J, et al. Diagnosis and management of Waldenström macroglobulinaemia - a British Society for Haematology guideline. Br J Haematol. 2022 Apr;197(2):171-87.
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