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Macroglobulinemia of Waldenstrom

• Overview
• Symptoms
• Treatment

Alternative Names:

Waldenstrom's macroglobulinemia; Macroglobulinemia - primary;

Lymphoplasmacytic lymphoma

Symptoms:

• Fatigue
• Easy bruising of the skin
• Rash
• Nosebleeds (epistaxis)
• Bleeding of the gums
• Unintentional weight loss
• Vision loss in one eye
• Headache
• Dizziness
• Blurred or decreased vision
• Mental status changes
• Peripheral neuropathy (changes in the nerves affecting the hands, feet, fingers, toes, ears, or nose) manifested by:
  • Numbness or tingling
  • Burning pain

Additional symptoms that may be associated with this disease:

• Swollen glands
• Flank pain
• Bluish skin discoloration
• Fingers that change color upon pressure

Signs and tests:

A physical examination may reveal a swollen spleen , liver, and lymph nodes. An eye exam may show enlarged veins in the retina or retinal bleeding (hemorrhages).

A CBC shows a low number of red bloods and platelets. A blood chemistry shows evidence of kidney disease . A serum viscosity test can tell if the blood has become thick. Symptoms usually occur when the blood is four times thicker than normal.

A test called serum protein electrophoresis shows an increased amount of the IgM antibody. Levels seen in Waldenstrom's macroglobulinemia are generally greater than 3 g/dL.

Bone lesions are very rare. If they are present, a bone marrow examination will show cells that resemble both lymphocytes and plasma cells.

Additional tests that may be done:

• 24-hour urine protein
• Total protein
• Serum globulin electrophoresis
• Immunofixation in urine
• T (thymus derived) lymphocyte count

References:

Ferri FF. Ferri’s Clinical Advisor: Instant Diagnosis and Treatment. 8th ed. St. Louis, Mo: Mosby; 2006:909.

Goldman L, Ausiello D. Cecil Textbook of Medicine. 22nd ed. Philadelphia, Pa: WB Saunders; 200:1068, 1992.

• Review Date: 9/20/2006
• Reviewed By: Corey Cutler, MD, MPH, FRCP(C), Assistant Professor of Medicine, Harvard Medical School; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA. Review provided by VeriMed Healthcare Network.

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