SEMINAR IN HAEMATOLOGY

Take home message from SEMINAR IN HAEMATOLOGY

• Every patient that came with complaint of back pain, put Multiple myeloma as one of differential diagnosis
• A mnemonic sometimes used to remember the common tetrad (four parts) of multiple myeloma is CRAB:     
• C = Calcium (elevated)(corrected calcium >2.75 mmol/L)
• R = Renal failure
• A = Anemia (hemoglobin <10 g/dL)
• B = Bone lesions. (lytic lesions or osteoporosis with compression fractures)
• The presence of unexplained anemia, kidney dysfunction, a high erythrocyte sedimentation rate(ESR) and a high serum protein (especially raised immunoglobulin) may prompt further testing. 
• Will request protein electrophoresis of the blood and urine (Bence Jones protein), which might show the presence of a paraprotein (monoclonal protein, or M protein) band, with or without reduction of the other (normal) immunoglobulins (known as immune paresis).