Multiple myeloma laboratory tests
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]
Overview
Laboratory findings consistent with the diagnosis of multiple myeloma include abnormal complete blood count, erythrocyte sedimentation rate (ESR), basic metabolic panel, electrophoresis and immunohistochemistry. An elevated concentration of serum protein level without concomitant elevation of serum albumin level is very suggestive of multiple myeloma.[1][2][3]
Laboratory Findings
Complete blood count[1][2]
Peripheral blood smear
- Rouleaux formation of red blood cells[1][2]
Basic metabolic panel[1][2]
- Hypercalcemia due to increased osteoclasts activity
- Increased serum creatinine level due to reduced renal function
- Abnormal blood urea nitrogen
- High alkaline phosphatase level
- High serum protein level with normal/decreased albumin level
Urinalysis[1][2]
- A 24-hour collection of urine is usually needed to examine the amount of protein
Electrophoresis[1][2]
- Protein electrophoresis is a method that separates proteins in the serum or urine
- 70% of cases have high levels of IgG
- 20% of cases have high levels of IgA
- 5–10% of cases have only immunoglobulin light chains (Bence Jones proteins)
- Rarely κ- or λ-light chains may be secreted in isolation
Free light chain immunoassay
Immunofixation
- Identifies the type of M-protein or immunoglobulin light chain detected by serum or urine electrophoresis[1][2]
Quantitative immunoglobulin assay[1][2]
- Quantitative measurement of IgA, IgG, IgM immunoglobulins to detect immune paresis
- Monoclonal gammopathy (IgA and/or IgG peak)
- Reverse albumin:globulin ratio (low albumin, high globulin)
- Elevated β2-microglobulin level
Immunohistochemistry
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 Multiple myeloma. Wikipedia(2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015
- ↑ Rajkumar SV, Kumar S (January 2016). "Multiple Myeloma: Diagnosis and Treatment". Mayo Clin. Proc. 91 (1): 101–19. doi:10.1016/j.mayocp.2015.11.007. PMC 5223450. PMID 26763514.