Tag Archives: myeloma

Case 91 – summary

Thank you for all your contributions this week! This week we had a look at MGUS (monoclonal gammopathy of undetermined significance). Our patient was diagnosed with IgA lambda MGUS, which was monitored 6 monthly for 4 years. This then progresses … Continue reading

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Case 91 – update 2

We have been monitoring our patient 6 monthly for 4 years. His para protein has been slowly rising and was 10g/l on his last visit 3 months ago. He has been bought to clinic slightly earlier to monitor his paraprotein. … Continue reading

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Case 91 – update 1

So our patient has been seen by haematology. He initially presented with shoulder pain. Following X-ray and MRI this has been shown to be due to osteoarthritis with no evidence of lytic lesions. Bone marrow had shown a normocellular marrow … Continue reading

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Case 91 – the beginning

Welcome to this week’s TeamHaem case! This week we start in general practice. A 70 year old man saw your colleague complaining of shoulder pain. Some bloods were done as he was due his ‘well man’ bloods around the same … Continue reading

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Case 88 – summary

Morphology week summary. Case A     Our followers were correct in suggesting these were plasma cells, one of which is binucleate on the second picture.  Thrombocytopenia was also noted.  This would be in keeping with a diagnosis of plasma … Continue reading

Posted in Chronic leukaemia, Laboratory morphology, Lymphoma, Myeloma/paraproteins | Tagged , , , , , , , , ,

Case 88 – part A

This week we are going to do some quick fire morphology cases. Cases will be centered around a blood film, then added questions based on the diagnosis our followers come up with. Please feel free to add interesting pictures of … Continue reading

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Case 85 – summary

So, our patient has had quite a week! Thanks to your efforts, he is safely back on the ward, conscious and improving.  Recap: We have managed an emergency presentation of an unconscious patient with severe hypercalcaemia, hyperviscosity and an AKI. … Continue reading

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Case 85 – update 2

We rejoin our patient on HDU… He remains unconscious and lacks capacity to currrently make decisions regarding his further management.  Based on our team’s suspicion of an underlying plasma cell disorder, that may be driving our patient’s hypercalcaemia, AKI and … Continue reading

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Case 85 – update 1

Thank you for all your help so far on the medical admissions unit. Assessment Our patient was initially assessed using an ABCDE approach: A) Snoring, requiring an airway adjunct (nasopharangeal airway) B) RR16, chest clear to auscultation, sats 97% room … Continue reading

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Case 75 – summary

Case 75 – Summary! Thank you for all of the contributions with Case 75, where we encountered a 43 year old who presented with back pain and circulating plasma cells in his peripheral blood. In summary we established that this … Continue reading

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Case 75 – update 3

Bortezomib-based regimes are associated with better outcomes as it more rapidly reduces tumour load and reverses complications. What would you combine Bortezomib with in our patient? How would you consolidate this treatment if response achieved? Would the cytogenetics results influence … Continue reading

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Case 69 – part 3 – summary

During this short case we looked at serum protein electrophoresis. This showed a band in the gamma region and immunofixation confirmed a IgM kappa paraprotein. IgM paraproteins are commonly associated with MGUS, low grade lymphoma and rarely myeloma. Typically IgM … Continue reading

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Case 69 – part 3 – the beginning

Thanks for contributing! Please use #TeamHaem in your reply on Twitter!   A 69 year old gentleman presents to his GP with headache and visual blurring. Giant cell arteritis is suspected as the ESR is 120mm/hr. A serum protein electrophoresis … Continue reading

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Case 54 – case D

  Case D 45 year old gentleman complaining of back pain. Hb 120 g/l, calcium 2.33 mmol/L, creatinine 75 IgG 34g/L Serum involved:non-involved light chains – 115 BM – 35% plasma cells MRI – no lytic lesions How would you … Continue reading

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Case 50 part 3 – summary

It just goes to show that picking up on simple signs can lead to the start of a diagnostic journey. The patient with the film below (second from left) had a FBC as she had suffered from back pain and … Continue reading

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Case 50 part 3 – the beginning

You are reviewing the blood films from today. Can you make a diagnosis without a microscope?     Please reply to us (@TeamHaem) on Twitter and always include #TeamHaem to allow others to follow your comments. Please join in the … Continue reading

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Case 48 – #UnofficialCSIM2 summary

Thank you for joining the case. We’ve already met Mr Jones, a 75 year old man admitted following a fall to an orthopaedic ward with a fractured neck of femur. We agreed that his behaviour was new and odd and … Continue reading

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Case 48 – #UnofficialCSIM2 update 1

Thanks for joining the case, where as a surgical FY1 doctor you were asked to review Mr  Jones, a 75 year old man who had been admitted after a fall leading to a femur fracture. The nurses were worried that … Continue reading

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Case 48 – UnofficialCSIM2 – oncology week

Hi to all those joining us from #unofficialCSIM2. To remind our usual teamhaem-ers again – the #unofficialCSIM2 project is aimed at 4th year medical students. Whilst everyone’s input is appreciated, it would be helpful if those of you with more … Continue reading

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Case 47 – summary

Thank you for all your help with this weeks case! We have had some very helpful renal input this week! This week we looked at the case of a normally fit 60year old gentleman who presented with peripheral oedema and … Continue reading

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