Tag Archives: Paraprotein

Case 47 – update 2

So we have another update on our gentleman. He has been found to have nephrotic syndrome and a renal biopsy has been performed which has now come back and is consistent with AL Amyloid nephropathy. Further investigations revealed an IgG … Continue reading

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Case 47 – update 1

Here is our first update on our 60 year old gentleman, who only has childhood asthma in his pmh. He initially presented with ankle swelling and despite 20mg furosemide he felt it was getting slightly worse at his second visit. … Continue reading

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Case 47 – the beginning

Welcome to our new case! This week we start in a GP surgery. Our patient is a 60 year old gentleman who has come to see you with some ankle swelling.  He saw your partner 4 weeks ago with the … Continue reading

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Case 27 – summary

This case was all about evaluating a patient with a paraprotien.  A paraprotein is a specific immunoglobulin produced by a clone of plasma or lymphoid cells.  The immunoglobulin is composed of heavy chain and a light chain (either kappa or … Continue reading

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Case 27 – update 5

Our patient has a small IgG lambda paraprotein along with plasma cells in the marrow.  She has orthostatic hypotension, peripheral neuropathy and heart failure. Because of this the team were keen to investigate the possibility of amyloidosis. In order to … Continue reading

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Case 27 – update 3

Our anaemic patient has a small paraprotein (IgG lambda, 4.6g/L). When finding a paraprotein it is important to think of the differentials: MGUS Asymptomatic myeloma Plasma cell myeloma AKA multiple myeloma or simply myeloma Non-Hodgkin lymphoma (e.g. Waldenström’s macroglobulinaemia) POEMS syndrome … Continue reading

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Case 27 – update 2

Thank you so far for your contributions via #TeamHaem on Twitter.  The start of case 27 can be found below… The patient states she gets dizzy when standing up and indeed she has postural hypotension. This is attributed to her … Continue reading

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Case 4 – summary

The debate on twitter illustrates the multiple differentials that exist in this situation. Most people pointed out that amyloidosis could cause the symptoms and signs described in the case (hepatomegaly due to infiltration, cardiomyopathy causing peripheral oedema, nephrotic syndrome causing … Continue reading

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Case 4 – update 2

The patient is counselled regarding the presence of  a paraprotein and kept under regular follow up. After 3 years his paraprotein has risen only slightly to 14g and he is briefly lost to follow up due to personal problems. When … Continue reading

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Case 4 – update 1

The patient is generally fit and well, with no bone pain, B symptoms or neuropathic symptoms. He has had diarrhoea intermittently for a number of years, interspersed with bloating and constipation. The gastroenterologists felt the history was of classical Irritable … Continue reading

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Case 4 – the beginning

A 45 year old man is referred to Haematology clinic. He has had a battery of blood tests requested by the gastroenterologists who were investigating him for diarrhoea. These investigations revealed little except for the presence of an IgG paraprotein … Continue reading

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