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What Are The Symptoms Of Multiple Myeloma?
Question: Good evening, could someone please describe what kinds of abnormalities, if any, might be expected on a CBC or metabolic panel for an individual with multiple myeloma? I understand that diagnosis of this disease requires much more specific lab tests like protein electrophoresis, but my next appointment with my hematologist is not scheduled for a month and I'm wondering if having a completely normal CBC and comprehensive metabolic panel might lower the suspicion of multiple myeloma. Or might a person have completely normal lab values on these tests and still have multiple myeloma?
Should also mention that CRP and ESR were both very low and well within normal range.
Should also mention that CRP and ESR were both very low and well within normal range.
Brief Answer:
SIGNS OF MULTIPLE MYELOMA
Detailed Answer:
Dear XXXXXXX
Thanks for questioning through health care magic.
The signs and symptoms of multiple myeloma depend upon the stage of the disease - localised or generalised bony pains with CBC showing mild or gross anaemia in the form of hemoglobin lower than normal associated with general weakness, lethargy, reduced capacity to work. CBC may show raised ESR, low platelets, metabolically there may be raised alkaline phosphatase, normal or high calcium levels, urine may show presence of proteins, if kidneys are affected there may be renal damage causing higher creatinine level. Radiologically there may be bony lesions particularly in flat bones like skull and ribs in the form of eaten out lesions also called punched out lesions or moth eaten appearance. Some people have neurological involvement particularly spine leading to neurological deficit. Latter we need serum electrophoresis to see particular band of the raised protein, even immunoelectrophoresisis is required to know the extent of disease. There are many more investigations which includes detailed study of bone marrow - uou look for plasma cells. Rest of the investigations is for prognostic study.
With these signs and symptoms you can imagine even if you have normal CBC do you fit in myeloma set up.
Ii hope I have answered your query.
truly,
DR. J. TICKU
SIGNS OF MULTIPLE MYELOMA
Detailed Answer:
Dear XXXXXXX
Thanks for questioning through health care magic.
The signs and symptoms of multiple myeloma depend upon the stage of the disease - localised or generalised bony pains with CBC showing mild or gross anaemia in the form of hemoglobin lower than normal associated with general weakness, lethargy, reduced capacity to work. CBC may show raised ESR, low platelets, metabolically there may be raised alkaline phosphatase, normal or high calcium levels, urine may show presence of proteins, if kidneys are affected there may be renal damage causing higher creatinine level. Radiologically there may be bony lesions particularly in flat bones like skull and ribs in the form of eaten out lesions also called punched out lesions or moth eaten appearance. Some people have neurological involvement particularly spine leading to neurological deficit. Latter we need serum electrophoresis to see particular band of the raised protein, even immunoelectrophoresisis is required to know the extent of disease. There are many more investigations which includes detailed study of bone marrow - uou look for plasma cells. Rest of the investigations is for prognostic study.
With these signs and symptoms you can imagine even if you have normal CBC do you fit in myeloma set up.
Ii hope I have answered your query.
truly,
DR. J. TICKU
Above answer was peer-reviewed by :
Dr. Prasad
Thanks very much Dr. Ticku. I'll be getting blood and possibly urine electrophoresis testing soon. In the meantime, however, if it's okay with you I'd like to describe the pain I'm experiencing to see if it sounds characteristic of multiple myeloma bone pain, because I'm not really sure if it's bone pain or muscular to be honest: my lower back pain is of a very sharp, stabbing nature and it's highly dependent upon position. If I'm up and walking around it very rarely bothers me, and there's never any problem when I'm lying down. It comes on primarily when I'm in a certain seated position for any extended period and becomes worse when I go to stand up, but once up it goes away quickly for the most part. Also, I should point out that I have had pain of this nature since at least 2012, and I believe at least initially it was due to straining while weight lifting. The only change in this pain, really, is that it has become more chronic. When it started years ago it would be there for a day or two, leave for weeks or even months, and then repeat. Whereas it's more or less a daily occurrence now. Does this sound characteristic of myeloma or might this just be normal?
With regard to the leg pain, this is very intermittent (probably only occurs once every other week) and it more or less feels like muscular pain, but it's kind of strange because in my experience when I pull a muscle or have soreness from exercise the area is usually somewhat tender to the touch, whereas my leg pain is not increased at all by rubbing the area. I should also point out that this pain really "jumps around," meaning that I'll have soreness in one leg for a few hours, then that will stop and the soreness will transfer to the other side. The soreness seems to originate in my buttocks and extend down the back of my thighs. Again, does the nature of this pain sound characteristic of myeloma?
Thank you very much!
With regard to the leg pain, this is very intermittent (probably only occurs once every other week) and it more or less feels like muscular pain, but it's kind of strange because in my experience when I pull a muscle or have soreness from exercise the area is usually somewhat tender to the touch, whereas my leg pain is not increased at all by rubbing the area. I should also point out that this pain really "jumps around," meaning that I'll have soreness in one leg for a few hours, then that will stop and the soreness will transfer to the other side. The soreness seems to originate in my buttocks and extend down the back of my thighs. Again, does the nature of this pain sound characteristic of myeloma?
Thank you very much!
Brief Answer:
Multiple myeloma
Detailed Answer:
DEAR XXXXXXX
THANKS FOR POSING AGAIN. YES CRP IS LIKELY TO GO UP BUT IS NOT FINALLY DIAGNOSTIC. THERE ARE MANY OTHER CONDITIONS WHICH GIVE RISE TO SUCH TYPE OF BONY PAINS CAUSED BY RARIFICATION OF BONES. IT IS STILL BETTER TO EXCLUDE THEM ONE BY ONE. BONE MARROW BIOPSY WILL BE THE FINAL TEST TO EXCLUDE MYELOMA WHERE YOU HAVE SOME EVIDENCE OF ABNORMAL PLASMA CELLS AND WILL GIVE THE DIRECTION IF YOU NEED TO GO FOR FURTHER EXPLORATION FOR MULTIPLE MYELOMA. IT HAS TO BE CONFIRMED BY RADIOLOGICAL, IMMUNOLOGICAL AND HEMATOLOGICAL EVIDENCE. SINCE MULTIPLE MYELOMA IS IN MIND AT LEAST ELECTROPHORESIS WILL SHOW IF THERE IS ANY ABNORMAL BAND. WHEN ALL INVESTIGATIONS ARE THERE AS I SUGGESTED IN MY EARLIER POST AS WELL MULTIPLE MYELOMA CAN BE RULED OUT. I WILL TELL YOU HA GOOD THING THAT MULTIPLE MYELOMA CANNOT STAY SO LONG AND YOU NEED TO TAKE SYMPTOMATIC MEASURES TO ALLEVIATE BONY PAINS WITH BONE MODIFYING AGENTS LIKE CHOLECALCIFEROL, VIT D ETC.
HOPE I RESPONDED TO YOU TO YOUR SATISFACTION
TRULY,
DR, J. TICKU
Multiple myeloma
Detailed Answer:
DEAR XXXXXXX
THANKS FOR POSING AGAIN. YES CRP IS LIKELY TO GO UP BUT IS NOT FINALLY DIAGNOSTIC. THERE ARE MANY OTHER CONDITIONS WHICH GIVE RISE TO SUCH TYPE OF BONY PAINS CAUSED BY RARIFICATION OF BONES. IT IS STILL BETTER TO EXCLUDE THEM ONE BY ONE. BONE MARROW BIOPSY WILL BE THE FINAL TEST TO EXCLUDE MYELOMA WHERE YOU HAVE SOME EVIDENCE OF ABNORMAL PLASMA CELLS AND WILL GIVE THE DIRECTION IF YOU NEED TO GO FOR FURTHER EXPLORATION FOR MULTIPLE MYELOMA. IT HAS TO BE CONFIRMED BY RADIOLOGICAL, IMMUNOLOGICAL AND HEMATOLOGICAL EVIDENCE. SINCE MULTIPLE MYELOMA IS IN MIND AT LEAST ELECTROPHORESIS WILL SHOW IF THERE IS ANY ABNORMAL BAND. WHEN ALL INVESTIGATIONS ARE THERE AS I SUGGESTED IN MY EARLIER POST AS WELL MULTIPLE MYELOMA CAN BE RULED OUT. I WILL TELL YOU HA GOOD THING THAT MULTIPLE MYELOMA CANNOT STAY SO LONG AND YOU NEED TO TAKE SYMPTOMATIC MEASURES TO ALLEVIATE BONY PAINS WITH BONE MODIFYING AGENTS LIKE CHOLECALCIFEROL, VIT D ETC.
HOPE I RESPONDED TO YOU TO YOUR SATISFACTION
TRULY,
DR, J. TICKU
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Sonia Raina
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