It is the second most common adult hematological malignancy, and the most frequent site to involve is the skeleton. Multiple myeloma (plasma cell myeloma, myelomatosis, or Kahler disease) is a rare form of cancer, with approximately 114,000 new cases globally per year. Multiple causes of renal failure occur in myeloma and are often present at the time of diagnosis. Absence of paraprotein in the blood does not exclude multiple myeloma. It was further observed that most of the patients presented with significant renal damage, which attributed to hyperuricemia, hypercalcemia, or high NLR. Most patients were diagnosed at stage III. In this study, unfortunately, the laboratory investigations were insufficient for diagnosing this disease in most patients. Most patients presented in stage III.Ĭonclusions: The presence of anemia, high ESR, and low A/G ratio in elderly patients should alert the clinician to investigate along the lines of multiple myeloma. Light chain multiple myeloma patients had high α2 globulin concentration and normal A/G ratio. Apart from the diagnosis of multiple myeloma, a number of cases had varying diagnoses including the following: 4% non-secretory myeloma, 2% amyloidosis with nephrotic syndrome, 2% liver cirrhosis, and 18.2% renal failure. In 26.5% of cases, the only diagnosis was multiple myeloma. IgG was the commonest type, followed by IgA then light chain. Bence Jones protein was positive in 50% cases.

Of the hypergammaglobulinemia, 18.1% showed polyclonal gammaglobulinemia. Hypogammaglobulinemia was detected in 32.8% and hypergammaglobulinemia was detected in 49.2%. Monoclonal bands were seen in 44 cases (95.7%) and a bi-clonal pattern in two cases (4.3%), 78% of M-band showed migration to γ-region of electrophoretogram and 18% to β-region. Serum protein electrophoresis revealed a localized band in 70.8% of patients. Other abnormal serum levels with regard to the cases are as follows: hyperproteinemia in 30%, low albumin/globulin (A/G) ratio in 54.2%, hypercalcemia in 11.3%, serum creatinine level of >2.0 mg/dL in 27.2% cases, and increased β2-microglobulin in 67%. High erythrocyte sedimentation rate (ESR) was seen in 65.3% of cases and increased neutrophil-to-lymphocyte ratio (NLR) was seen in 29.7%. Anemia was seen in roughly half of the diagnosed cases, most of which was normocytic normochromic anemia. The mean age was 61 years, of which 42 (42.4%) were males and 57 (57.6%) were females. Results: Of the 99 study detected cases of multiple myeloma at diagnosis, 14% were younger than 45 years and 35% were 70 years or older. Information on the laboratory features was obtained at presentation (before treatment) and analyzed. Materials and methods: A retrospective study of 99 patients diagnosed with multiple myeloma (MM) was carried out at the Hematology Department of Benghazi Medical Center (BMC) in Benghazi, Libya from January 2010 to March 2017. The purpose of the retrospective study was to assess the hematological profile, different biochemical parameters, and the serum electrophoresis patterns of patients consistent with clinical symptoms of multiple myeloma. It is the second most common adult hematological malignancy, and it is the most common cancer with skeletal components as its primary site.

In rare cases where other thyroid function tests do not confirm the diagnosis, high levels of reverse T3 help rule out a diagnosis of secondary hypothyroidism.Objectives: Multiple myeloma (MM) is a malignant disorder characterized by proliferation of a single clone of plasma cells derived from β-cells in the bone marrow. In these situations, the body produces reverse T3 (rT3), which is an inactive form of T3. Sick euthyroid syndrome shows up in reduced levels of T3, T4 and TSH in individuals who have normal thyroid and pituitary gland function but who are suffering from a major health condition (anorexia, trauma, hemorrhagic shock, severe infection, etc.). When the TSH levels are also low, it means there could be a problem with the pituitary gland (secondary hypothyroidism) and further investigation is necessary. Therefore, when T3 and T4 levels are low, it is normal for TSH levels to be high. When T3 and T4 levels are too low to meet the body’s energy needs, the pituitary gland secretes more TSH to stimulate the thyroid gland. Their secretion is controlled by TSH, a hormone produced by a small gland known as the pituitary gland (hypophysis) located at the base of the brain. The thyroid gland is responsible for producing two hormones: T3 and T4.

Reverse ag ratio