Macroglobulinemia of Waldenstrom

Alternative names:

macroglobulinemia - primary; Waldenstrom's macroglobulinemia

Symptoms:

• fatigue
• easy bruising of the skin
• rash
• nosebleeds (epistaxis)
• bleeding of the gums
• weight loss
• vision loss in one eye
• headache
• dizziness
• blurred vision
• decreased vision
• mental status changes
• weight loss
• peripheral neuropathy (changes in the nerves affecting the hands, feet, fingers, toes, ears, or nose) manifested by
  • numbness
  • tingling
  • burning pain

Additional symptoms that may be associated with this disease:

• glands, swollen
• flank pain
• skin discoloration, bluish
• fingers that change color upon pressure

Signs and tests:

A physical examination may reveal an enlarged spleen, liver, and lymph nodes. A retinal eye examination (examination of the eye with an ophthalmoscope) may reveal enlarged (engorged) retinal veins or retinal hemorrhages.

• A CBC shows low red blood cell count and platelet count.
• Serum protein electrophoresis shows a monoclonal spike (increased amount of a monoclonal protein). This may be seen as a serum immunoelectrophoresis that shows an IgM spike or a serum immunofixation that shows an IgM spike.
• Urine immunoelectrophoresis shows IgM or a urine test for urine Bence-Jones proteins (quantitative) may be positive.

Bone lesions are very rare. If they are present, a bone marrow examination will show cells that resemble both lymphocytes and plasma cells. A blood chemistry shows evidence of renal disease.

This disease may also alter the results of the following tests:

• 24-hour urine protein
• total protein
• serum globulin electrophoresis
• positive immunofixation - urine (possibly)
• T (thymus derived) lymphocyte count