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J. I. Anetor F I Ajose T. S Akingbola 《Indian journal of clinical biochemistry : IJCB》2005,20(1):193-197
A 64-year-old security guard and longstanding known hypertensive presented with hypertensive heart disease (HHD), weight loss,
an enlarged prostate, and a spontaneously fractured rib. Malignancy of the prostate with possible metastases to the ribs was
strongly suspected. Biochemical profiling revealed a paraprotein. Other biochemical and hematological correlates that were
on hand before serum protein electrophoresis were rather atypical. Paraprotein studies by immunofixation revealed IgA myelomatosis.
Unlike previous reports from Caucasians there was normocalcaemia, normal protein level, microcytic hypochromia, low MCHC,
cholesterol level at the lower limit of the reference range and normal urea level (in the face of markedly raised creatinine
level). Nutritional modulation of the classical laboratory features of this disease may account for the fairly atypical laboratory
picture.
The need to appreciate the influence of nutritional status on the laboratory (especially biochemical) features of a disease
and thus interpretation of diagnostic tests appears of exceptional current importance, given the widening gap in socioeconomic
status and the level of poverty between the resource poor and developed countries from which the classical, clinical and laboratory
features of most diseases were first described.
This case report reminds of the need not only to recognize theoretically the impact of nutritional status on the laboratory
characteristics of a disease but of the practical application of the nutritional perspective in the interpretation of diagnostic
investigations, especially in nutritionally disadvantaged communities. 相似文献
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Nihar Ranjan Dash Biswajit Mohanty 《Indian journal of clinical biochemistry : IJCB》2012,27(1):100-102
Multiple myeloma is a group of B-cell disorders resulting in the secretion of a specific and unique monoclonal immunoglobulin
(M-protein). Protein electrophoresis is advised whenever multiple myeloma is suspected. The monoclonal protein migrates as
a single entity in the electric field and is detected by the non-specific protein stain as a more intensely stained band superimposed
on the usual protein pattern. The M-protein usually migrates in the gamma or beta region of the normal protein pattern; very
rarely it may appear in the α2 or even in α1 region. Here we have given an atypical case presentation where the patient with
multiple myeloma presented with two M-spike one each in α2 and β-globulin region on agarose gel protein electrophoresis with
hypoglobulinemia but with reversed A:G ratio. 相似文献
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