laboratory features
Last reviewed 01/2018
The hallmark of Waldenstrom's macroglobulinaemia is the presence of a monoclonal IgM spike on serum protein electrophoresis in the beta or gamma globulin region.
Other features:
- increased serum viscosity
- anaemia - usually normochromic, normocytic; occasionally haemolytic
- raised ESR
- marked rouleaux formation; +ve Coomb's test
- bone marrow sections - hypercellular; infiltrated by the plasmacytic lymphocytes which are also present on peripheral blood
- Bence Jones proteinuria in at least 10% of cases
- x-rays should be normal; renal failure is unusual
- IgM may cause cryoglobulinaemia