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Exam Cram
Exam Cram
Lymphocytes differentiate into B cells in lymph nodes and then plasma cells, which produce antibodies
Plasma cell dyscrasias are cancerous plasma cells producing excess antibodies which cause organ specific problems
Types:
Myeloma is caused by the effects of cancerous plasma cells on the kidney and bone marrow
Waldenstrom's Macroglobulinaemia is a lymphoma, where the cancerous B cell becomes a plasma cell
Amyloidosis causes antibodies (protein) build up in heart, causing e.g. restrictive cardiomyopathy
In Cyroglobulinaemia excessive antibodies (proteins) build up in the skin, causing a rash
Plasma cell dyscrasias
Plasma cell dyscrasias
These are a group of disorders that are caused by defects in the plasma cell
They can be confusing (to me!) hence this page helps compare and clarify the differences. In summary all four conditions produce excess antibodies (immunoglobulins) however the diseases are defined by the effects the excess antibodies have upon the organs.
Definitions
Definitions
Immunoglobulins, antibodies and proteins:
Antibodies are a type of immunoglobulins and immunoglobulins are a type of protein
Some immunoglobulins are not antibodies but all all immunoglobulins are proteins
Some proteins are immunoglobulins and some aren't
Subclassess of immunoglobulin: IgG, IgM, IgA, IgD, IgE
Raised monoclonal antibody: high levels of one specific antibody, specific to one specific cell. This can be a sign of cancer in the plasma cell that produces that antibody.
Haematology Basics
Haematology Basics
Bone marrow stem cell divides into a myeloid or lymphoid cell in the bone marrow. Cancer of the myeloid or lymphoid cell is leukaemia.
The lymphoid cells migrate into the lymph nodes and become either a B cell lymphocyte, T cell lymphocyte or Natural Killer cell. Cancer of these cells is lymphoma.
The B cell cannot produce antibodies, however it may develop into a Plasma Cell, which can. Disorders of the Plasma Cells are called Plasma Cells Dsycrasias
A reasonable Multiple myeloma definition:
Raised mono-immunoglobulin: IgG or IgA
Dysfunction: CRAB- hypercalcaemia, renal disease, anaemia, boney pain
MGUS is defined as a raised immunoglobulins without dysfunction, usually IgG or IgA.
Therefore in MM and MGUS the cancer is in the B cells.
WM is a type of Plasma Cell Dyscrasia and B Cell Lymphoma.
Firstly there is a B cell lymphoma. This cannot produce antibodies. However rarely the cancerous B Cell Lymphocytes develop into cancerous plasma cells that do produce antibodies. In WM, the cancerous plasma cells produce excess IgM. IgM is a large protein, hence 'macro' within WM. Excess of this large protein produces hyperviscosity symptoms in WM, such as headaches.
Amyloidosis occurs when there is cancer within the plasma cell, resulting in excess antibody productions. These antibodies clump together to produce amyloid plaques causing organ damage. The site of damage dictates the symptoms of amyloidosis. Amyloidosis in summary is defined by the presence of problematic amyloid plaques.
These amyloid plaques can result in cardiomyopathy, renal disease and is hypothesised to be linked with the amyloid plaques in Alzheimer's disease.
There are a number of types of amyloidosis but the most relevant here is AL- light chain amyloidosis. These light chains are similar to the proteins produced in Multiple Myeloma however in amyloidosis for amyloid clumps causing amyloidosis rather than the CRAB myeloma symptoms.
Cryoglobulinaemia can be broken into:
Cryo = cold
Globulin = protein
Aemia = blood
Therefore cyroglobulinaemia means an accumulation of proteins in the blood that thicken at cold temperatures. This thickening allows them to be
Cryoglobulinaemia can either be a monoclonal (type 1) or polyclonal (type 2) excess. The protein's produce the symptoms (SKAN):
Skin: rash
Kidney disease: mesangiocapillary disease
Arthralgia
Neuromas
Page written in 2024.
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