It bone marrow is being replaced with myeloma cells.2

It is suspected that the patient
has multiple myeloma. Multiple myeloma is caused when plasma cells start to
accumulate in the bone marrow of a patient.1 The main giveaway would
be the monoclonal elevation in the electrophoresis. The elevation could be
caused by either an immunoglobulin or a Bence Jones proteins (light chain
proteins).1 The patient also has several symptoms that would
indicate multiple myeloma. Even though, pain in the limbs isn’t very common for
multiple myeloma patients, back and rib pain are. In fact, the back fracture
that the patient suffered is fairly common, and can happen with just a minor
fall or lifting something. 2  The decreased red blood cell count would
indicate that the patient has anemia. Anemia can happen in multiple myeloma
patients because the bone marrow is being replaced with myeloma cells.2  The decrease in immunoglobulin’s is also
characteristic of multiple myeloma. The decrease in the immunoglobulin’s means
that there are uninvolved in the cancer.2

electrophoresis is used check for the presence of light chain proteins in
either urine or serum. 3 There is a discrepancy between the serum
and the urine protein electrophoresis. The serum protein electrophoresis showed
a small spike in the, and the urine sample had a large spike. There are a
variety of possible reasons for this discrepancy. One reason could simply be
the patient. Every patient will have different test results, so the discrepancy
could just be patient variation.4 The discrepancy could also depend
on the handling of the specimens, or the collection of the specimens.4
Human error is a great source of variation in the laboratory.  Sometimes, the spike is not measurable in a
serum sample, so urine has to be done.3  

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                  To ensure that the diagnosis is accurate, an
immunofixation electrophoresis should be done. Immunofixation electrophoresis
is often done to get an idea of which proteins are causing the monoclonal band.5  On the gel, the monoclonal band will
appear as one solid band, while the polyclonal, or immunoglobulins, will
diffuse across band region. When an immunoelectrophoresis is done, the results
are compared with a normal gel pattern, so the technician can properly identify
which immunoglobulin or light chain protein is abnormal.6
Immunofixation is more sensitive than protein electrophoresis, and can also be
used to monitor treatment of the patient.