Sunday, January 13, 2008

How to Diagnose Multiple Myeloma


Multiple myelomas are malignant tumors that originate in bone marrow. They result from a proliferation of plasma cells that subsequently overproduce a monoclonal immunoglobin, usually type A or G. This can cause a wide range of symptoms and can include plasma cell leukemia. The ailments caused by multiple myeloma can be lessened with therapy but no cure exists. The following steps will show how to diagnose multiple myelomas.


Difficulty: Challenging



Step One

Identify the initial symptoms of multiple myelomas. These usually include anemia, fatigue, hypercalcemia, pathologic fractures, renal failure and spinal cord compression. Asymptomatic patients are becoming increasingly identified with routine blood screening.

Step Two

Conduct a physical exam of the patient. This may reveal pallor from the anemia and purplish patches on the skin resulting from a reduced concentration and platelets in the blood. The bone lesions or fractures caused by multiple myelomas typically result in pain but not tenderness.

Step Three

Perform detailed laboratory studies on the patient. A diagnosis of multiple myeloma based on the patient's blood and metabolic chemistry is quite complex but includes a complete blood count to check for a decrease in leukocytes, platelets and red blood cells. A metabolic panel also should be run to measure the albumin and globulin, blood urea nitrogen, creatinine, total protein and uric acid.

Step Four

Use imaging scans to aid in diagnosing multiple myeloma. A diffuse reduction in bone calcification and density may indicate myeloma before the lesions are visible.

Step Five

Include a histological analysis of a biopsy to support but not confirm the diagnosis of multiple myeloma. Affected plasma cells will typically have cytoplasmic inclusions that contain immunoglobulin.

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