It is suspected that the patienthas multiple myeloma.
Multiple myeloma is caused when plasma cells start toaccumulate in the bone marrow of a patient.1 The main giveaway wouldbe the monoclonal elevation in the electrophoresis. The elevation could becaused by either an immunoglobulin or a Bence Jones proteins (light chainproteins).1 The patient also has several symptoms that wouldindicate multiple myeloma. Even though, pain in the limbs isn’t very common formultiple myeloma patients, back and rib pain are. In fact, the back fracturethat the patient suffered is fairly common, and can happen with just a minorfall or lifting something.
2 The decreased red blood cell count wouldindicate that the patient has anemia. Anemia can happen in multiple myelomapatients because the bone marrow is being replaced with myeloma cells.2 The decrease in immunoglobulin’s is alsocharacteristic of multiple myeloma.
The decrease in the immunoglobulin’s meansthat there are uninvolved in the cancer.2 Proteinelectrophoresis is used check for the presence of light chain proteins ineither urine or serum. 3 There is a discrepancy between the serumand the urine protein electrophoresis. The serum protein electrophoresis showeda small spike in the, and the urine sample had a large spike. There are avariety of possible reasons for this discrepancy. One reason could simply bethe patient. Every patient will have different test results, so the discrepancycould just be patient variation.
4 The discrepancy could also dependon the handling of the specimens, or the collection of the specimens.4Human error is a great source of variation in the laboratory. Sometimes, the spike is not measurable in aserum sample, so urine has to be done.3 To ensure that the diagnosis is accurate, animmunofixation electrophoresis should be done. Immunofixation electrophoresisis often done to get an idea of which proteins are causing the monoclonal band.
5 On the gel, the monoclonal band willappear as one solid band, while the polyclonal, or immunoglobulins, willdiffuse across band region. When an immunoelectrophoresis is done, the resultsare compared with a normal gel pattern, so the technician can properly identifywhich immunoglobulin or light chain protein is abnormal.6Immunofixation is more sensitive than protein electrophoresis, and can also beused to monitor treatment of the patient.