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Myeloma Screen
 
 
Myeloma Screen
Multiple myeloma may present with typical features such as hypercalcaemia, renal dysfunction, anaemia and bony lesions. This section outlines the tests used to screen for multiple myeloma.
 

Serum Immunoglobulins

 
 

Overview

  • Immunoglobulins, secreted by plasma cells, are made up of five classes - IgG, IgM, IgA, IgD and IgE.
    • Roles of Immunoglobulins

    • IgG - the most abundant immunoglobulin; also crosses the placenta
    • IgM - the first immunoglobulin secreted in response to foreign antigens
    • IgA - present in saliva, sweat, tears, breast milk and blood
    • IgD - bound to B-cell membranes; triggers B-cell activation
    • IgE - present in skin, mucous membranes and the lungs; involved in certain hypersensitivity reactions and response to parasitic infection
  • IgD and IgE are trace immunoglobulins and are not normally assessed.
  • Antibodies directed against specific pathogens (e.g. hepatitis B IgM and IgG) are useful in clinical practice, though total serum immunoglobulin levels are also useful for detecting inflammation, oligoclonal / monoclonal gammopathies and hypogammaglobulinaemia.

Elevated Immunoglobulins

    • Causes of Elevated Immunoglobulins

    • Infection
    • Inflammatory disease
    • Malignancy
    • Causes of Single Ig Elevation

    • Plasma Cell Neoplasms

    • Multiple myeloma
    • Smouldering myeloma
    • Monoclonal gammopathy of uncertain significance (MGUS)
    • Solitary plasmacytoma
    • AL amyloidosis
    • Others

    • Waldenstrom’s macroglobulinaemia
    • Chronic lymphocytic leukaemia (CLL)
    • Non-Hodgkin lymphoma (NHL)
    • Monoclonal (type II) cryoglobulinaemia

Hypogammaglobulinaemia

    • Causes of Hypogammaglobulinaemia

    • Inherited

    • Primary hypogammaglobulinaemia
    • Reduced Production

    • Malnutrition
    • Malignancy - especially CLL, lymphoma, multiple myeloma
    • Inflammatory disease - SLE, rheumatoid arthritis
    • Viruses - HIV, EBV, CMV, rubella
    • Increased Consumption

    • Sepsis
    • Severe burns
    • Protein-losing enteropathy
    • Nephrotic syndrome
Last updated on August 12th, 2018
 
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Associated Diseases
BETA

Haematology
Lymphoma
Infectious Diseases
Other
 
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