1/13/2017. Blood work... when to worry? Part 2. Bryan E. Martin MD Medical Director Benefis Sletten Cancer Institute. Blood work When to worry?

Size: px
Start display at page:

Download "1/13/2017. Blood work... when to worry? Part 2. Bryan E. Martin MD Medical Director Benefis Sletten Cancer Institute. Blood work When to worry?"

Transcription

1 Blood work... when to worry? Part 2 Bryan E. Martin MD Medical Director Benefis Sletten Cancer Institute Blood work When to worry? part 2 Abnormal Iron Studies Abnormal Globulin Tumor markers...next time Normal iron metabolism Iron absorption in duodenum and jejunum Iron loss through GI tract, menses, sweat Enters plasma bound to transferrin receptor and the iron/transferrin complex delivered into cells Storage primarily in RBC s, liver, marrow, REC s Disorders in absorption, storage, iron transfer and iron loss lead to abnormal iron metabolism 1

2 Iron metabolism Iron lab values Serum iron measure the iron bound to transferrin Total Iron Binding Capacity (TIBC) measures the amount of transferrin Percent iron saturatin (% sat) percentage of transferrin bound by iron Ferritin iron storage molecule found in all organs but mostly in the liver. Iron deficiency The primary clinical presentation is iron deficiency anemia 2

3 Iron deficiency Low serum iron Low ferritin Normal TIBC Microcytic RBC s Elevated platelet count Never a normal finding...seek the diagnosis Treatment... Iron... One way or the other Iron overload FERRITIN will fool you Over 300 ng/ml suggests iron overload Over 1000 ng/ml may not be overload Ferritin is easy, but not fool proof, way to assess body iron stores Ferritin elevated by... infection, NASH, inflammation (metabolic syndrome), liver disease, cancer Gold standard for iron overload remains liver biopsy, and maybe MRI Iron Overload Causes Blood transfusions Liberated iron from hemolysis Supplementation Thalassemia (genetically abnormal forms of hemoglobin) Porphyria (dysfunctional synthesis leads to build up of toxic porphyrins) Hepatitis B and C Hemochromatosis 3

4 Iron Overload Elevated ferritin does not mean Hemochromatosis Hemochromatosis Iron overload syndrome resulting from genetic mutation in HFE gene. Leads to increased efficiency in intestinal iron absorption Mutation in the C282Y or H63E gene present. Homozygous state needed for disease Gene mutations present in up to 10% of Celtic, English, Scandinavians There are many individuals with elevated ferritin and abnl HFE genes who do not have hemochromatosis Hemochromatosis Excess iron is stored in various organs and slowly causes organ dysfunction Liver cirrhosis Pancreas diabetes Heart cardiomyopathy Endocrine system Skin bronze Diagnosis requires proof of organ iron overload (biopsy or MRI) and appropriate genetics. Percent Iron saturation over 62% very suggestive 4

5 Hemochromatosis 35 year old female with elevated ferritin on screening labs...no family history. Hemochromatosis Hemochromatosis 5

6 Iron Overload Elevated ferritin does not mean Hemochromatosis Iron overload algorithm 6

7 Serum proteins identified by position on serum protein electrophoresis Primarily represents serum immunoglobulin SIEP allows identification of the immunoglobulin class Gammaglobulin classes IgG, IgA, IgM, IgD, IgE Each class also has kappa and lamda subclasses Causes 7

8 Majority of causes are inflammation, liver diseases, clonal plasma cell disorders Clonal plasma cell disorders MGUS Monoclonal Gammopathy of Uncertain Significance (MGUS) Serum globulin less than 3 g/dl Less than 10% plasma cells in marrow No end organ damage: CRAB Calcium Renal failure Anemia (hg less than 10) Bone Neuropathy? Clonal (malignant) expansion of plasma cells in the marrow or other tissues Diagnosis requires bone marrow bx and CRAB assessment Skeletal survey is convenient, MRI is superior Treatment depends on degree of end organ damage, genetic abnormalities, and is becoming increasingly complicated 8

9 Examples Examples examples 9

10 Example free light chain assay Examples 10

11 Blood work... when to worry? Part 2 Bryan E. Martin MD Medical Director Benefis Sletten Cancer Institute 11

Serum & urine protein electrophoresis

Serum & urine protein electrophoresis Serum & urine protein electrophoresis Take a test Normal or abnormal? Definitions Electrophoresis is a method of separating proteins based on their physical properties. Serum is placed on a specific

More information

Recommendations for the Diagnosis and Management of Hemochromatosis

Recommendations for the Diagnosis and Management of Hemochromatosis Recommendations for the Diagnosis and Management of Hemochromatosis Individuals with hemochromatosis retain too much iron which may be toxic to the tissues in which it is stored. Acquired hemochromatosis:

More information

Haemoglobin Haemproteins Haem porhyrins porphyrias Iron Fe ++ /Fe +++

Haemoglobin Haemproteins Haem porhyrins porphyrias Iron Fe ++ /Fe +++ Haemoglobin Haemproteins Haem porhyrins porphyrias Iron Fe ++ /Fe +++ 1 3 4 PORPHYRIAS A group of rare disorders caused by deficiencies of enzymes of the heme biosynthetic pathway. The majority of the

More information

Diagnosis of Monoclonal Gammopathies

Diagnosis of Monoclonal Gammopathies Diagnosis of Monoclonal Gammopathies Julio C. Delgado, MD, MS Assistant Professor of Pathology Director Immunology Laboratory, ARUP Laboratories Associate Director H&I Laboratory, University of Utah Health

More information

UNDERSTANDING MULTIPLE MYELOMA AND LABORATORY VALUES Benjamin Parsons, DO bmparson@gundersenhealth.org Gundersen Health System Center for Cancer and

UNDERSTANDING MULTIPLE MYELOMA AND LABORATORY VALUES Benjamin Parsons, DO bmparson@gundersenhealth.org Gundersen Health System Center for Cancer and UNDERSTANDING MULTIPLE MYELOMA AND LABORATORY VALUES Benjamin Parsons, DO bmparson@gundersenhealth.org Gundersen Health System Center for Cancer and Blood Disorders La Crosse, WI UNDERSTANDING MULTIPLE

More information

Proteins. Learning Objectives. Optimizing electrophoresis

Proteins. Learning Objectives. Optimizing electrophoresis Proteins Michael A. Pesce, Ph.D Director of the Specialty Laboratory New York-Presbyterian Hospital Clinical professor of Pathology Columbia University Medical Center Learning Objectives Describe the electrophoresis

More information

Proteins. Protein Trivia. Optimizing electrophoresis

Proteins. Protein Trivia. Optimizing electrophoresis Proteins ELECTROPHORESIS Separation of a charged particle in an electric field Michael A. Pesce, Ph.D Department of Pathology New York-Presbyterian Hospital Columbia University Medical Center Rate of migration

More information

Hereditary Hemochromatosis Making the Diagnosis in Primary Care

Hereditary Hemochromatosis Making the Diagnosis in Primary Care Hereditary Hemochromatosis Making the Diagnosis in Primary Care Catherine Moltzan MD FRCPC Associate Professor, Department of Internal Medicine, University of Manitoba Topics to be Discussed Epidemiology

More information

Monoclonal Gammopathy of Undetermined Significance (MGUS) Facts

Monoclonal Gammopathy of Undetermined Significance (MGUS) Facts Monoclonal Gammopathy of Undetermined Significance (MGUS) Facts Normal plasma cells (a type of white blood cell) produce antibodies (also known as immunoglobulins) which help fight infection. Each type

More information

M-protein in multiple myeloma

M-protein in multiple myeloma M-protein in multiple myeloma Plasma cells produce immunoglobulins (also called gammaglobulins), which consist of a heavy chain (IgG, IgA, IgM, IgD or IgE) and a light chain (kappa or lambda) linked together.

More information

Laboratory Studies in the Diagnosis of Iron Deficiency, Latent Iron Deficiency and Iron Deficient Erythropoiesis

Laboratory Studies in the Diagnosis of Iron Deficiency, Latent Iron Deficiency and Iron Deficient Erythropoiesis Laboratory Studies in the Diagnosis of Iron Deficiency, Latent Iron Deficiency and Iron Deficient Erythropoiesis General Comments The laboratory studies listed below are helpful in the diagnosis and management

More information

Specialty. Ferritin. Analyte Information

Specialty. Ferritin. Analyte Information Specialty Ferritin Analyte Information 1 2011-04-04 Ferritin Introduction Ferritin is an intracellular iron-binding protein that stores iron and releases it in a controlled fashion. The protein is produced

More information

Iron Metabolism. Brenda Shinar, MD Associate Program Director Department of Internal Medicine Banner University Medical Center-Phoenix

Iron Metabolism. Brenda Shinar, MD Associate Program Director Department of Internal Medicine Banner University Medical Center-Phoenix Iron Metabolism Brenda Shinar, MD Associate Program Director Department of Internal Medicine Banner University Medical Center-Phoenix Case ID and CC: 45 year old man Sepsis UTI vs. Sacral Wound Hemodynamic

More information

QUICK QUERIES. The Highs and Lows of Ferritin. Sharon E. Card, MD, MSc, FRCPC Presented at Common Medical Problems, November 2005

QUICK QUERIES. The Highs and Lows of Ferritin. Sharon E. Card, MD, MSc, FRCPC Presented at Common Medical Problems, November 2005 053-Quick Queries:053-Quick Queries 4/17/07 1:45 PM Page 53 QUICK QUERIES The Highs and Lows of Ferritin Sharon E. Card, MD, MSc, FRCPC Presented at Common Medical Problems, November 2005 Aferritin test

More information

Excess iron may accumulate in these 3 normal storage sites and also in other organs that don t normally store iron, such as the:

Excess iron may accumulate in these 3 normal storage sites and also in other organs that don t normally store iron, such as the: What is Iron Overload? Iron overload occurs when you have too much iron in your body. This can be a problem for people who get lots of red blood cell transfusions. Red blood cells contain iron. Each time

More information

Updated Diagnostic Criteria in Multiple Myeloma: The Impact on Your Clinical Practice

Updated Diagnostic Criteria in Multiple Myeloma: The Impact on Your Clinical Practice Welcome to Managing Myeloma. My name is Sergio Giralt, and I am a professor of medicine at Weill Cornell Medical College. I am the Melvin Berlin Family Chair in Myeloma Research and chief of the Adult

More information

MULTIPLE MYELOMA 1 PLASMA CELL DISORDERS Multiple l Myeloma Monoclonal Gammopathy of Undetermined Significance (MGUS) Smoldering Multiple Myeloma (SMM) Solitary Plasmacytoma Waldenstrom s Macroglobulinemia

More information

Understanding Serum Free Light Chain (Freelite ) Assays. Judith A. Finlay Ph.D. Director of Scientific Affairs The Binding Site, Inc.

Understanding Serum Free Light Chain (Freelite ) Assays. Judith A. Finlay Ph.D. Director of Scientific Affairs The Binding Site, Inc. Understanding Serum Free Light Chain (Freelite ) Assays Judith A. Finlay Ph.D. Director of Scientific Affairs The Binding Site, Inc. San Diego, CA Outline Background Tests used to Assess Multiple Myeloma

More information

Things You Don t Want to Miss in Multiple Myeloma

Things You Don t Want to Miss in Multiple Myeloma Things You Don t Want to Miss in Multiple Myeloma Sreenivasa Chandana, MD, PhD Attending Hematologist and Medical Oncologist West Michigan Cancer Center Assistant Professor, Western Michigan University

More information

Hepatitis C. Laboratory Tests and Hepatitis C

Hepatitis C. Laboratory Tests and Hepatitis C Hepatitis C Laboratory Tests and Hepatitis C If you have hepatitis C, your doctor will use laboratory tests to check your health. This handout will help you understand what the major tests are and what

More information

Hemoglobin Structure

Hemoglobin Structure Hemoglobin Structure Hemoglobin (Hb) is synthesized in a complex series of steps. The heme part is synthesized in a series of steps in the mitochondria and the cytosol of immature red blood cells, while

More information

Any process that can disrupt the normal life span of a red blood cell may cause anemia. Normal life span of a red blood

Any process that can disrupt the normal life span of a red blood cell may cause anemia. Normal life span of a red blood How deal with a case of Anemia What is anemia? Anemia is a medical condition in which the red blood cell count and hemoglobin is less than normal for age and sex. Most common hematologic disorder by far

More information

Serum Free Light Chain Assays. The Binding Site, Inc. San Diego, CA

Serum Free Light Chain Assays. The Binding Site, Inc. San Diego, CA Understanding Serum Free Light Chain Assays Karen H van Hoeven MD Karen H. van Hoeven, MD The Binding Site, Inc. San Diego, CA Why Understand d Lab Test Results? Diabetes: blood sugar Heart disease: cholesterol

More information

Examination. Sample. Adult- Yellow top. Sample Tube/Container

Examination. Sample. Adult- Yellow top. Sample Tube/Container Examination 17749 Protein Electrophoresis (Total protein, albumin, Bence jones protein, serum protein electrophoresis SPE, myeloma, and other B cell dyscrasias screen) Purpose of test The main reasons

More information

1.5 Function of analyte For albumin, see separate entry. The immunoglobulins are components of the humoral arm of the immune system.

1.5 Function of analyte For albumin, see separate entry. The immunoglobulins are components of the humoral arm of the immune system. Total protein (serum, plasma) 1 Name and description of analyte 1.1 Name of analyte Total protein 1.2 Alternative names None 1.3 NMLC code 1.4 Description of analyte This is a quantitative measurement

More information

Multiple Myeloma Patient s Booklet

Multiple Myeloma Patient s Booklet 1E Kent Ridge Road NUHS Tower Block, Level 7 Singapore 119228 Email : ncis@nuhs.edu.sg Website : www.ncis.com.sg LIKE US ON FACEBOOK www.facebook.com/ nationaluniversitycancerinstitutesingapore Multiple

More information

Ferritin. Objectives. Marilyn Zeman November 2013 GI for GPs

Ferritin. Objectives. Marilyn Zeman November 2013 GI for GPs Marilyn Zeman November 2013 GI for GPs Ferritin Objectives Outline the causes and complications of hyperferritinemia and iron overload syndromes. Identify when an elevated ferritin suggests hereditary

More information

HEMATOLOGY CLINICAL PEARLS

HEMATOLOGY CLINICAL PEARLS HEMATOLOGY CLINICAL PEARLS Rakhi Naik, MD, MHS Assistant Professor of Medicine & Oncology, Division of Hematology Disclosures None Case #1 A 21-year-old Greek female presents to her PCP for establishment

More information

Hemochromatosis. National Digestive Diseases Information Clearinghouse

Hemochromatosis. National Digestive Diseases Information Clearinghouse Hemochromatosis National Digestive Diseases Information Clearinghouse What is hemochromatosis? Hemochromatosis is the most common form of iron overload disease. Too much iron in the body causes hemochromatosis.

More information

Unusual complication of Iron Overload : Hemochromatosis (?)

Unusual complication of Iron Overload : Hemochromatosis (?) Unusual complication of Iron Overload : Hemochromatosis (?) James J. Stark, MD, FACP Medical Director Cancer Program and Palliative Care Maryview Medical Center November 20, 2009 Case Presentation 47 y.o.

More information

Anemia. Presented by Dr. Frederick Lloyd Palo Alto Medical Foundation Palo Alto, California

Anemia. Presented by Dr. Frederick Lloyd Palo Alto Medical Foundation Palo Alto, California Anemia Presented by Dr. Frederick Lloyd Palo Alto Medical Foundation Palo Alto, California Terms RBC = red blood cells Hgb = hemoglobin MCV = mean cell volume Fe = iron SD = standard deviation TIBC = total

More information

Tumor Markers IDEAL TUMOR MARKERS. Michael A. Pesce, PhD Department of Pathology. Columbia-Presbyterian Medical Center COMMON TUMOR MARKERS

Tumor Markers IDEAL TUMOR MARKERS. Michael A. Pesce, PhD Department of Pathology. Columbia-Presbyterian Medical Center COMMON TUMOR MARKERS IDEAL TUMOR MARKERS Tumor Markers Michael A. Pesce, PhD Department of Pathology Columbia-Presbyterian Medical Center Be specific to the tumor Level should change in response to tumor size An abnormal level

More information

IRON METABOLISM DISORDERS

IRON METABOLISM DISORDERS IRON METABOLISM DISORDERS ANEMIA Definition Decrease in the number of circulating red blood cells Most common hematologic disorder by Most common hematologic disorder by far 1 Blood loss ANEMIA Causes

More information

FastTest. You ve read the book... ... now test yourself

FastTest. You ve read the book... ... now test yourself FastTest You ve read the book...... now test yourself To ensure you have learned the key points that will improve your patient care, read the authors questions below. Please refer back to relevant sections

More information

Haemochromatosis: The Celtic Disease

Haemochromatosis: The Celtic Disease What is the Celtic Disease? It is a genetic disorder and the medical term for it is Hereditary Haemochromatosis (HH). The name Celtic Disease comes from the fact that it is most commonly found in Celtic

More information

The Chemistry of Hematology. Gary L. Horowitz, MD Beth Israel Deaconess Medical Center Boston, MA

The Chemistry of Hematology. Gary L. Horowitz, MD Beth Israel Deaconess Medical Center Boston, MA The Chemistry of Hematology Gary L. Horowitz, MD Beth Israel Deaconess Medical Center Boston, MA Objectives Explain how methylmalonic acid and homocysteine are related to B 12 and folate deficiencies List

More information

USA dataset Blood test ICD code ICD description PLATELET COUNT 038 Septicemia PLATELET COUNT 197 Secondary malignant neoplasm of respiratory and

USA dataset Blood test ICD code ICD description PLATELET COUNT 038 Septicemia PLATELET COUNT 197 Secondary malignant neoplasm of respiratory and USA dataset Blood test ICD code ICD description PLATELET COUNT 038 Septicemia PLATELET COUNT 197 Secondary malignant neoplasm of respiratory and digestive systems PLATELET COUNT 511 Pleurisy PLATELET COUNT

More information

C. No nucleus and no mitochondria 1. Where did it go relationship to reticulocytes? 4. Does this mean you can t make new RBCs?

C. No nucleus and no mitochondria 1. Where did it go relationship to reticulocytes? 4. Does this mean you can t make new RBCs? I. Characteristics of Erythrocytes A. Biconcave discs--what purpose does this serve? B. 1/3 hemoglobin by volume (remember this with hematocrit) (Fig. 19.4, pg. 673) 1. Heme 2. Globin 3. Fe 4. Oxyhemoglobin

More information

Chain Test. Linda Traylor, Ph.D. Technical Director The Binding Site, Inc. San Diego, CA

Chain Test. Linda Traylor, Ph.D. Technical Director The Binding Site, Inc. San Diego, CA Understanding the Serum Free Light Chain Test Linda Traylor, Ph.D. Technical Director The Binding Site, Inc. San Diego, CA Objectives Plasma Cell Involvement and Immunoglobulin Proteins Importance of Serum

More information

Ferritin. 1

Ferritin.  1 Ferritin A ferritin blood test checks the amount of ferritin in the blood. Ferritin is a protein in the body that binds to iron; most of the iron stored in the body is bound to ferritin. Ferritin is found

More information

Anemia in children. Wilbur Pan, M.D., Ph.D. Pediatric Hematology/Oncology Bristol-Myers-Squibb Children s Hospital Cancer Institute of New Jersey

Anemia in children. Wilbur Pan, M.D., Ph.D. Pediatric Hematology/Oncology Bristol-Myers-Squibb Children s Hospital Cancer Institute of New Jersey Anemia in children Wilbur Pan, M.D., Ph.D. Pediatric Hematology/Oncology Bristol-Myers-Squibb Children s Hospital Cancer Institute of New Jersey Common Conditions Not Referred (Hematology/Oncology). Diagnose

More information

Erythropoeisis in Burn Patients. Gordon Lindberg MD, PhD. Medical Director Burn Unit University of Colorado Health Sciences Center Denver, Colorado

Erythropoeisis in Burn Patients. Gordon Lindberg MD, PhD. Medical Director Burn Unit University of Colorado Health Sciences Center Denver, Colorado Erythropoeisis in Burn Patients Gordon Lindberg MD, PhD. Medical Director Burn Unit University of Colorado Health Sciences Center Denver, Colorado Blood Transfusions Carry Risk Blood Transfusions Carry

More information

Understanding Serum Free Light Chain Assays

Understanding Serum Free Light Chain Assays Understanding Serum Free Light Chain Assays International Myeloma Foundation 12650 Riverside Drive, Suite 206 North Hollywood, CA 91607 USA Telephone: 800-452-CURE (2873) (USA & Canada) 818-487-7455 Fax:

More information

Page 1 of 28 MEDSEM9_H15_ORD. Answer paper. Examination: MEDSEM9_H15_ORD

Page 1 of 28 MEDSEM9_H15_ORD. Answer paper. Examination: MEDSEM9_H15_ORD Page 1 of 28 Answer paper Examination: MEDSEM9_H15_ORD Page 13 of 28 Assessment: MEDSEM9_STATION20_H15_ORD Part 1: was 7, 8 g/100ml (11.3-12.3). Determine the likelihood of each of the following diagnoses:

More information

Medicare Limited Coverage Tests

Medicare Limited Coverage Tests Iron Studies, Serum National Coverage Determination CPT Codes: 82728 Ferritin 83540 Iron 83550 Iron binding capacity 84466 Transferrin Numerical Sort: 002.0-002.9 Typhoid and paratyphoid fevers 003.0-003.9

More information

IRON METABOLISM DISORDERS

IRON METABOLISM DISORDERS IRON METABOLISM DISORDERS ANEMIA Definition Decrease ease in the number of circulating cu red blood cells Most common hematologic disorder by far Blood loss ANEMIA Causes Decreased production of red blood

More information

MGUS. This Infosheet explains what Monoclonal Gammopathy of Undetermined Significance (MGUS) is and how it is diagnosed and managed.

MGUS. This Infosheet explains what Monoclonal Gammopathy of Undetermined Significance (MGUS) is and how it is diagnosed and managed. MGUS This Infosheet explains what Monoclonal Gammopathy of Undetermined Significance (MGUS) is and how it is diagnosed and managed. What is MGUS? MGUS is a benign (non-cancerous) condition. MGUS stands

More information

chronic leukemia lymphoma myeloma differentiated 14 September 1999 Pre- Transformed Ig Surface Surface Secreted Myeloma Major malignant counterpart

chronic leukemia lymphoma myeloma differentiated 14 September 1999 Pre- Transformed Ig Surface Surface Secreted Myeloma Major malignant counterpart Disease Usual phenotype acute leukemia precursor chronic leukemia lymphoma myeloma differentiated Pre- B-cell B-cell Transformed B-cell Plasma cell Ig Surface Surface Secreted Major malignant counterpart

More information

Iron metabolism and disorders. Georg Stüssi DIM Fortbildung

Iron metabolism and disorders. Georg Stüssi DIM Fortbildung Iron metabolism and disorders Georg Stüssi DIM Fortbildung 8.12.2008 Iron metabolism Iron deficiency anemia Anemia of chronic disorders Iron overload Distribution of iron in adults Adult men 35 45mg iron/kg

More information

Definition: Red Blood Cell Count (RBC), or other laboratory parameters (HGB, PCV) are lower than normal.

Definition: Red Blood Cell Count (RBC), or other laboratory parameters (HGB, PCV) are lower than normal. ANEMIAS Anemia is usually a symptom, that is associated with another disease, e.g. with chronic inflammation or with malignancy. Definition: Red Blood Cell Count (RBC), or other laboratory parameters (HGB,

More information

Adams Memorial Hospital Decatur, Indiana EXPLANATION OF LABORATORY TESTS

Adams Memorial Hospital Decatur, Indiana EXPLANATION OF LABORATORY TESTS Adams Memorial Hospital Decatur, Indiana EXPLANATION OF LABORATORY TESTS Your health is important to us! The test descriptions listed below are for educational purposes only. Laboratory test interpretation

More information

FerriScan : be better informed. Using FerriScan in the assessment of liver status in hereditary haemochromatosis

FerriScan : be better informed. Using FerriScan in the assessment of liver status in hereditary haemochromatosis FerriScan : be better informed Using FerriScan in the assessment of liver status in hereditary haemochromatosis Hereditary Haemochromatosis Hereditary haemochromatosis is an inherited condition that causes

More information

Hereditary Haemochromatosis For Patients

Hereditary Haemochromatosis For Patients Hereditary Haemochromatosis For Patients What is Hereditary Haemochromatosis? Hereditary Haemochromatosis () is a common inherited disorder where the body absorbs too much iron from the diet. The iron

More information

Understanding Protein Electrophoresis

Understanding Protein Electrophoresis Understanding Protein Electrophoresis International Myeloma Foundation 12650 Riverside Drive, Suite 206 North Hollywood, CA 91607 USA Telephone: 800-452-CURE (2873) (USA & Canada) 818-487-7455 Fax: 818-487-7454

More information

Monoclonal Gammopathy of Undetermined Significance

Monoclonal Gammopathy of Undetermined Significance Monoclonal Gammopathy of Undetermined Significance Robert Vescio, MD Director Multiple Myeloma & Amyloidosis Program Samuel Oschin Comprehensive Cancer Center Cedars-Sinai Medical Center Los Angeles, CA

More information

SERUM FREE LIGHT CHAIN TESTING AND WALDENSTRÖM MACROGLOBULINEMIA by Neal Makens, MD

SERUM FREE LIGHT CHAIN TESTING AND WALDENSTRÖM MACROGLOBULINEMIA by Neal Makens, MD SERUM FREE LIGHT CHAIN TESTING AND WALDENSTRÖM MACROGLOBULINEMIA by Neal Makens, MD Introduction Antibodies (immunoglobulins) are proteins produced by plasma cells (and to a limited extent by their immediate

More information

Anemia Fact Sheet. American Nephrology Nurses Association. ANNA s Mission Statement.

Anemia Fact Sheet. American Nephrology Nurses Association. ANNA s Mission Statement. American Nephrology Nurses Association Anemia Fact Sheet Developed by: ANNA Hemodialysis Specialty Practice Network Anemia Fact Sheet Additional Information: American Nephrology Nurses Association East

More information

COMMON VARIABLE IMMUNODEFICIENCY

COMMON VARIABLE IMMUNODEFICIENCY COMMON VARIABLE IMMUNODEFICIENCY This booklet is intended for use by patients and their families and should not replace advice from a clinical immunologist. 1 Also available : CHRONIC GRANULOMATOUS DISEASES

More information

Southern Derbyshire Shared Care Pathology Guidelines. Diagnosis and Management of Myeloma

Southern Derbyshire Shared Care Pathology Guidelines. Diagnosis and Management of Myeloma Southern Derbyshire Shared Care Pathology Guidelines Diagnosis and Management of Myeloma When to screen for Myeloma and related disorders Not recommended to screen the normal population Clinical Symptoms,

More information

Metabolic Disorders , The Patient Education Institute, Inc. idg90101 Last reviewed: 08/14/2014 1

Metabolic Disorders , The Patient Education Institute, Inc.  idg90101 Last reviewed: 08/14/2014 1 Metabolic Disorders Introduction Metabolism is the process your body uses to make energy from the food you eat. Your body can use this fuel right away, or it can store the energy in your body tissues,

More information

Multiple Myeloma. The term multiple myeloma is considered to be synonymous with myeloma, plasma cell myeloma, active and symptomatic myeloma.

Multiple Myeloma. The term multiple myeloma is considered to be synonymous with myeloma, plasma cell myeloma, active and symptomatic myeloma. Multiple Myeloma. The term multiple myeloma is considered to be synonymous with myeloma, plasma cell myeloma, active and symptomatic myeloma. The intent is to positively identify patients with active or

More information

Autoimmune Hepatitis. Hili N. Morillas, MD November 1, 2004 Morning Report

Autoimmune Hepatitis. Hili N. Morillas, MD November 1, 2004 Morning Report Autoimmune Hepatitis Hili N. Morillas, MD November 1, 2004 Morning Report Definition! An unresolving inflammation of unknown cause.! Characterized by the presence of interface hepatitis and portal plasma

More information

Mix and Mingle Activity Questions for Bag

Mix and Mingle Activity Questions for Bag Questions for Bag What is Iron, where is it found and what is its primary role? There are two forms of Iron. What is the difference and what foods are they found in? Name two test that are done to check

More information

Anemia. Classification Schemes. Mark Wurster, M.D., F.A.C.P. The Ohio State University

Anemia. Classification Schemes. Mark Wurster, M.D., F.A.C.P. The Ohio State University Evaluation of Mark Wurster, M.D., F.A.C.P. The Ohio State University - Definition National Health and Nutrition Examination Survey (NHANES III) data- 10-28% of patients over 65 years are anemic One third

More information

Multiple Myeloma Workshop- Tandem 2014

Multiple Myeloma Workshop- Tandem 2014 Multiple Myeloma Workshop- Tandem 2014 1) Review of Plasma Cell Disorders Asymptomatic (smoldering) myeloma M-protein in serum at myeloma levels (>3g/dL); and/or 10% or more clonal plasma cells in bone

More information

Pulling the Plug on Cancer Cell Communication. Stephen M. Ansell, MD, PhD Mayo Clinic

Pulling the Plug on Cancer Cell Communication. Stephen M. Ansell, MD, PhD Mayo Clinic Pulling the Plug on Cancer Cell Communication Stephen M. Ansell, MD, PhD Mayo Clinic Why do Waldenstrom s cells need to communicate? Waldenstrom s cells need activating signals to stay alive. WM cells

More information

SWOG ONCOLOGY RESEARCH PROFESSIONAL (ORP) MANUAL VOLUME II MYELOMA CHAPTER 11 REVISED: SEPTEMBER 2014

SWOG ONCOLOGY RESEARCH PROFESSIONAL (ORP) MANUAL VOLUME II MYELOMA CHAPTER 11 REVISED: SEPTEMBER 2014 Introduction This disease site includes the following three malignancies: multiple myeloma, amyloidosis, and waldenstrom's macroglobulinemia. See pages 4 and 5 for descriptions of the latter two diseases.

More information

Hereditary haemochromatosis. Preventing infection. Information for patients Information for patients

Hereditary haemochromatosis. Preventing infection. Information for patients Information for patients Hereditary haemochromatosis Preventing infection Information for patients Information for patients 3 This leaflet has been written for people who have hereditary haemochromatosis (HH) or have a family

More information

Some Common Haematological Problems in General Practice. Dr Francis Matthey April 2015

Some Common Haematological Problems in General Practice. Dr Francis Matthey April 2015 Some Common Haematological Problems in General Practice Dr Francis Matthey April 2015 Some Common Haematological Problems in General Practice Dr Francis Matthey Consultant Haematologist Chelsea and Westminster

More information

Southern Derbyshire Shared Care Pathology Guidelines. MGUS (Monoclonal Gammopathy of Undetermined Significance)

Southern Derbyshire Shared Care Pathology Guidelines. MGUS (Monoclonal Gammopathy of Undetermined Significance) Southern Derbyshire Shared Care Pathology Guidelines MGUS (Monoclonal Gammopathy of Undetermined Significance) Purpose of guideline This guideline provides information about the risk stratification of

More information

Menstruating females Pregnancy Lactation Growing infants and children Erythropoietin treatment

Menstruating females Pregnancy Lactation Growing infants and children Erythropoietin treatment Guidelines for the Use of Serum Tests for Iron Deficiency (CLP 002) 1. Purpose Revised February, 2012 To provide clinicians with a concise reference document describing the appropriate laboratory tests

More information

CAMBRIDGE, Mass., Dec 09, 2013 (BUSINESS WIRE) -- --Sotatercept granted orphan status by the FDA for the treatment of beta-thalassemia

CAMBRIDGE, Mass., Dec 09, 2013 (BUSINESS WIRE) -- --Sotatercept granted orphan status by the FDA for the treatment of beta-thalassemia Dec. 9, 2013, 11:00 a.m. EST Acceleron and Celgene Report New Interim Clinical Data from Phase 2 Trial of Sotatercept in Beta-Thalassemia at 2013 American Society of Hematology Annual Meeting Dose-dependent

More information

Smouldering myeloma. Myeloma Infosheet Series. Other related conditions Infoline:

Smouldering myeloma. Myeloma Infosheet Series. Other related conditions Infoline: Smouldering myeloma This Infosheet provides information on what smouldering myeloma is, how it is diagnosed, what the treatment is and will explain the link between smouldering myeloma and active myeloma.

More information

The ABCs of the CBC. Donald S. Houston MD PhD Ryan Zarychanski MD MSc

The ABCs of the CBC. Donald S. Houston MD PhD Ryan Zarychanski MD MSc The ABCs of the CBC Donald S. Houston MD PhD Ryan Zarychanski MD MSc Disclosures FINANCIAL DISCLOSURE RELEVANT TO THIS PRESENTATION: Grants/Research Support: None Speaker bureau/honoraria: None Consulting

More information

HYPER IgM SYNDROME This booklet is intended for use by patients and their families and should not replace advice from a clinical immunologist.

HYPER IgM SYNDROME This booklet is intended for use by patients and their families and should not replace advice from a clinical immunologist. HYPER IgM SYNDROME This booklet is intended for use by patients and their families and should not replace advice from a clinical immunologist. 1 Also available : COMMON VARIABLE IMMUNODEFICIENCY CHRONIC

More information

HASPI Medical Anatomy & Physiology 13c Activity

HASPI Medical Anatomy & Physiology 13c Activity HASPI Medical Anatomy & Physiology 13c Activity Name(s): Period: Date: Blood appears to be just a red fluid, but is actually made up of many different types of cells, molecules, and liquids. The liquid

More information

Introduction to (type 1) Hereditary Hemochromatosis Classic (HHC)

Introduction to (type 1) Hereditary Hemochromatosis Classic (HHC) Introduction to (type 1) Hereditary Hemochromatosis Classic (HHC) Hereditary Hemochromatosis runs in families. If you have been diagnosed with HHC you should inform all blood relatives so that they can

More information

EXECUTIVE BLOOD WORK PANEL

EXECUTIVE BLOOD WORK PANEL EXECUTIVE BLOOD WORK PANEL Below is a list of all blood and urine testing done on the day of your Executive Medical. MALE Serum Glucose Random Serum Glucose Fasting Creatinine Uric Acid Sodium Potassium

More information

SOUTHWEST ONCOLOGY GROUP CLINICAL RESEARCH ASSOCIATE (CRA) MANUAL. MYELOMA CHAPTER 10 REVISED: March 2008

SOUTHWEST ONCOLOGY GROUP CLINICAL RESEARCH ASSOCIATE (CRA) MANUAL. MYELOMA CHAPTER 10 REVISED: March 2008 Introduction This disease site includes the following three malignancies: multiple myeloma, amyloidosis, and waldenstrom's macroglobulinemia. See pages 4 and 5 for descriptions of the latter two diseases.

More information

Waldenström Macroglobulinemia: The Burning Questions. IWMF Ed Forum May 18 2014 Morie Gertz MD, MACP

Waldenström Macroglobulinemia: The Burning Questions. IWMF Ed Forum May 18 2014 Morie Gertz MD, MACP Waldenström Macroglobulinemia: The Burning Questions IWMF Ed Forum May 18 2014 Morie Gertz MD, MACP Are my kids going to get this? Familial seen in approximately 5 10% of all CLL patients and can be associated

More information

Third line of Defense

Third line of Defense Lecture 21 & 22 - Chapter 15 Third line of Defense Specific immunity is a complex system of immune cells interacting against antigens Adaptive immunity Immune Response (IR) (mediated by B- & T-lymphocytes)

More information

Supara Leechasan,M.D Hematologist Bangkok Hospital 12 September 2016

Supara Leechasan,M.D Hematologist Bangkok Hospital 12 September 2016 Supara Leechasan,M.D Hematologist Bangkok Hospital 12 September 2016 From Greek meaning without blood Insufficient RBC mass to adequately deliver Oxygen to peripheral tissue Anemia is not a disease but

More information

MANAGEMENT AFTER DIAGNOSIS

MANAGEMENT AFTER DIAGNOSIS PRIMARY IMMUNODEFICIENCIES MANAGEMENT AFTER DIAGNOSIS MANAGEMENT AFTER DIAGNOSIS 1 PRIMARY IMMUNODEFICIENCIES ABBREVIATIONS ALT Alanine transaminase AST Aspartate aminotransferase BUN Blood urea nitrogen

More information

MULTIPLE MYELOMA Review & Update for Primary Care. Dr. Joseph Mignone 21st Century Oncology

MULTIPLE MYELOMA Review & Update for Primary Care. Dr. Joseph Mignone 21st Century Oncology MULTIPLE MYELOMA Review & Update for Primary Care Dr. Joseph Mignone 21st Century Oncology OVERVIEW Identify the diagnostic criteria for multiple myeloma Compare first & second line therapies, using data

More information

Multiple Myeloma How to Evaluate Response To Treatment and Relapse

Multiple Myeloma How to Evaluate Response To Treatment and Relapse Multiple Myeloma How to Evaluate Response To Treatment and Relapse D R L. G AR D E R E T Saint Antoine Hospital, Paris Haematology Department 1 What is Multiple Myeloma? 4 Diagnostic Tools 8 Response to

More information

Elevated Liver Enzymes Workup, When to Worry, When to Refer

Elevated Liver Enzymes Workup, When to Worry, When to Refer Elevated Liver Enzymes Workup, When to Worry, When to Refer Ontario College of Family Physicians Annual Scientific Assembly Barry Lumb No disclosures Liver Biochemistry Bilirubin Hepatocellular - AST,

More information

Malignant Lymphomas and Plasma Cell Myeloma

Malignant Lymphomas and Plasma Cell Myeloma Malignant Lymphomas and Plasma Cell Myeloma Dr. Bruce F. Burns Dept. of Pathology and Lab Medicine Overview definitions - lymphoma lymphoproliferative disorder plasma cell myeloma pathogenesis - translocations

More information

AKB-6548 clinical development overview early clinical studies (CI-0001 to CI-

AKB-6548 clinical development overview early clinical studies (CI-0001 to CI- AKB-6548 clinical development overview early clinical studies (CI-0001 to CI- 0004, and CI-0006) To date, AKB-6548 has been studied in 8 clinical trials across 4 separate patient populations: healthy volunteers

More information

Multiple Myeloma Awareness, Diagnosis, and Disparities

Multiple Myeloma Awareness, Diagnosis, and Disparities Multiple Myeloma Awareness, Diagnosis, and Disparities 11 th Annual National Leadership Summit on Health Disparities Innovation Towards Reducing Disparities Congressional Black Caucus Health Braintrust

More information

Protein electrophoresis is used to categorize globulins into the following four categories:

Protein electrophoresis is used to categorize globulins into the following four categories: Globulin Globulin is one of the two types of serum proteins, the other being albumin. This generic term encompasses a heterogeneous series of families of proteins, with larger molecules and less soluble

More information

Patterns of abnormal LFTs and their differential diagnosis

Patterns of abnormal LFTs and their differential diagnosis Patterns of abnormal LFTs and their differential diagnosis Professor Matthew Cramp South West Liver Unit and Peninsula Schools of Medicine and Dentistry, Plymouth Summary liver function / liver function

More information

Collect and label sample according to standard protocols. Gently invert tube 8-10 times immediately after draw. DO NOT SHAKE. Do not centrifuge.

Collect and label sample according to standard protocols. Gently invert tube 8-10 times immediately after draw. DO NOT SHAKE. Do not centrifuge. Complete Blood Count CPT Code: CBC with Differential: 85025 CBC without Differential: 85027 Order Code: CBC with Differential: C915 Includes: White blood cell, Red blood cell, Hematocrit, Hemoglobin, MCV,

More information

Understanding the Serum Free Light Chain Assays. Anne L Sherwood, PhD Director of Scientific Affairs The Binding Site, Inc.

Understanding the Serum Free Light Chain Assays. Anne L Sherwood, PhD Director of Scientific Affairs The Binding Site, Inc. Understanding the Serum Free Light Chain Assays Anne L Sherwood, PhD Director of Scientific Affairs The Binding Site, Inc. AL Amyloidosis: abnormality of proteins from Plasma Cells in the Bone Marrow Red

More information

Blood Function. Hematopoietic System 3/11/2009. Introduction to the Hematopoietic and Lymphatic Systems. Chapter 36

Blood Function. Hematopoietic System 3/11/2009. Introduction to the Hematopoietic and Lymphatic Systems. Chapter 36 Introduction to the Hematopoietic and Lymphatic Systems Chapter 36 Blood Function Transports Oxygen and carbon dioxide Nutrients Hormones Waste products Maintains Acid base balance Fluid and electrolyte

More information

The Lymphatic System and Immunity

The Lymphatic System and Immunity 14 The Lymphatic System and Immunity Lymphatic System Definitions Pathogens Organisms that cause disease Lymphatic System Cells, tissues, and organs that play a central role in the body s defenses against

More information

Selective IgA deficiency (slgad) hello@piduk.org 0800 987 8986 www.piduk.org

Selective IgA deficiency (slgad) hello@piduk.org 0800 987 8986 www.piduk.org Selective IgA deficiency (slgad) hello@piduk.org 0800 987 8986 www.piduk.org About this booklet This booklet provides information on selective IgA deficiency (sigad). It has been produced by the PID UK

More information

MULTIPLE MYELOMA. Overview

MULTIPLE MYELOMA. Overview MULTIPLE MYELOMA Overview Steven R. Schuster, M.D. May 7, 2015 Objectives Give an overview of Multiple Myeloma Everything I know in 15 minutes Explain how genetic information can be used to personalize

More information

Key Points. The mean corpuscular volume (MCV) and corrected reticulocyte count can divide all anemias into 6 simple categories. Anemia Classification

Key Points. The mean corpuscular volume (MCV) and corrected reticulocyte count can divide all anemias into 6 simple categories. Anemia Classification Presenter Disclosure Information 7:45 8:45 am Evaluation of SPEAKER Andrew Eisenberger, MD The following relationships exist related to this presentation: Andrew Eisenberger, MD: No financial relationships

More information