A 75-year-old male patient presented with bone pain. His biochemical profile is shown below:
Parameter |
Patient Value |
Adult Normal Range |
Sodium |
140 mmol/L |
135 – 145 |
Potassium |
5.1 mmol/L* |
3.5 – 5.0 |
Chloride |
108 mmol/L* |
95 – 105 |
Bicarbonate |
21.0 mmol/L* |
22.0 – 26.0 |
Glucose |
6.0 mmol/L |
3.5 – 6.0 |
Urea |
25.0 mmol/L* |
3.0 – 8.0 |
Creatinine |
250 μmol/L* |
45 – 90 |
Magnesium |
1.10 mmol/L* |
0.75 – 0.95 |
Albumin |
25 g/L* |
35 – 50 |
Protein |
95 g/L* |
60 – 80 |
Total bilirubin |
26 μmol/L* |
< 26 |
Aspartate transferase |
60 U/L* |
< 35 |
Alanine transferase |
60 U/L* |
< 35 |
Alkaline phosphatase |
250 U/L* |
30 – 110 |
g-Glutamyl transferase |
40 U/L* |
< 40 |
Ionised calcium |
1.50 mmol/L* |
1.10 – 1.35 |
Calcium corrected |
2.90 mmol/L* |
2.12 – 2.62 |
Phosphate |
1.8 mmol/L* |
0.8 – 1.5 |
Lactate Dehydrogenase |
350 U/L* |
50 – 150 |
Beta2 microglobulin |
6 mg /L* |
< 1 |
a) Give the most likely diagnosis. (10% marks)
b) List the factors that may predispose to infection in this patient. (20% marks)
Not available.
Bone pain. He presents with bone pain.
a)
The abnormalities are:
So, this is multiple myeloma.
b)
Factors which increase the susceptibility to infection in myeloma and plasmacytoma are:
Kalambokis, G. N., L. Christou, and E. V. Tsianos. "Multiple myeloma presenting with an acute bacterial infection." International journal of laboratory hematology 31.4 (2009): 375-383.