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Multiple myeloma
Primary macroglobulinemia

Antibodies (immunoglobulins; IgG, IgA, IgM, IgD, IgE) are produced by plasma cells in the bone marrow and play a role in the immune response. The principal cause of multiple myeloma and primary macroglobulinemia is the excessive multiplication of plasma cells by canceration. Abnormal immunoglobulin called IgM or M protein is produced, and the detection of this marker is the key to the diagnosis.
Symptoms of multiple myeloma are lower back pain, back pain, bone pain, lassitude, fatigue, anemia, susceptibility to infection, proneness to fracture, protein in the urine, and elevated erythrocyte sedimentation rate. Common symptoms of primary macroglobulinemia are enlarged lymph nodes, liver, and spleen.
Elevated serum M protein levels increase blood viscosity, leading to circulatory disorders. The resulting deterioration in kidney function is another common symptom of multiple myeloma and primary macroglobulinemia. In addition to medical treatment, double filtration plasmapheresis (DFPP) or plasma exchange (PE) is used to reduce M protein levels to reduce viscosity and improve blood circulation.

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Thrombotic Thrombocytopenic Purpura (TTP)

"Purpura" is a general term for diseases characterized by purple staining of the skin or mucosa. The staining is caused by bleeding vessels near the skin or mucosal surface, which appears purple. The major causes are 1) vessel abnormality and 2) decrease in or abnormality of platelets. Thrombotic thrombocytopenic purpura (TTP) is a very rare disease caused by a decrease in the platelet count. The precise etiology of TTP is unknown, but small blood clots form in arterioles/capillary vessels throughout the body and numerous platelets are recruited for clotting, thus decreasing the platelet count. Symptoms include the subcutaneous/mucosal bleeding common in purpura, fever, hemolytic anemia, kidney failure, and neuropsychological disorders.
DFPP or PE is performed to eliminate causal factors and stimulate platelet-activating factor production.

Hemophilia

Hemophilia is a hereditary hematologic disorder caused by a lack or abnormality of coagulation factors. In hemophilia patients, the blood does not easily coagulate, and therefore any bleeding continues. Hemophilia A results from the lack or abnormality of blood coagulation factor VIII, while hemophilia B results from the lack or abnormality of blood coagulation factor IX. When inhibitors of blood coagulation factors are present, PE is performed to reduce them.

Cryoglobulinemia

Cryoglobulin is an abnormal antibody produced by plasma cells which precipitates at low temperature and redissolves at 37 degrees C. Cryoglobulinemia is a pathologil state when cryoglobulin is present in the blood. Cryoglobulin precipitation causes inflammation of blood vessels, resulting in symptoms including bruising, joint pain, and weakness. Patients may become hypersensitive to cold and show Raynaud's phenomenon, characterized by severe pain and cold urticaria of the extremities. Many patients have underlying diseases such as macroglobulinemia, cancer, autoimmune disease, and hepatitis C virus infection.
Steroids or immunosuppressants are administered, and DFPP or PE is performed to reduce cryoglobulin levels.