Case history
Case history #1
A 65-year-old white man, whose father died from lymphoma, presents with worsening fatigue, anorexia, and weight loss over the past 6 months. Blood test reveals anaemia, but iron, vitamin B12, folate, and other haematinics are normal.
Case history #2
A 70-year-old white man with a long history of worsening fatigue, unsteady gait, and intermittent numbness and pins-and-needles sensation in his lower legs, presents to the accident and emergency department with epistaxis, headache, and vision problems. His family says he has started to become confused recently. Physical examination reveals small-volume axillary and inguinal lymphadenopathy. Fundoscopy reveals a retinal haemorrhage in the right eye.
Other presentations
The most common presenting symptoms are fatigue and anorexia.[4] However, symptoms may range from being asymptomatic to being acutely unwell with symptoms of hyperviscosity and infections secondary to impaired immunity. There are no pathognomonic features for WM. However, the absence of lytic bone lesions and the presence of lymphadenopathy and splenomegaly in WM can differentiate it from multiple myeloma. In addition, multiple myeloma is usually associated with a different type of monoclonal protein to WM (e.g., IgG, IgA, IgD, IgE, or a light chain [kappa or lambda]); IgM multiple myeloma is very rare.
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