Thanks for your input. We’ve established that Myeloma is a particular concern in this patient. The following investigations were suggested:

• Calcium
• Serum electrophoresis
• Urine electrophoresis
• Serum free light chains
• Bone marrow biopsy
• Skeletal survey.

There are quite a few points to consider here.

What combination of results would convince you that this patient had Myeloma? What is considered a ‘positive’ serum electrophoresis result? 

What are serum free light chains? What information do they add?

Please reply on twitter and don’t forget to include the hashtag #teamhaem. There are no wrong answers and the more you join in the more you learn.

The case will evolve over the next two weeks so please continue to check this page and @teamhaem.