1. Plasma Cell Dyscrasis Sanambar Sadighi Hematologist-Oncologist Cancer Institute

2. Case presentation  65-y-old man with fatigue - caught- fever-generalized bone pain  CBC : WBC=10000(90%PMN) Hg=9(MCV92),Pla=150000

3. Suspicion  Anemia  Bone pain  Rise of creatinine  Weakness  Hypercalcemia  Weight loss  ESR>100

5. Plasma Cells

13. Case presentation  65-y-old man with fatigue - caught-fever- generalized bone pain  CBC : WBC=10000(90%PMN),Hg=9(MCV=92),Pla =150000  BUN=50,Cr=2.5  Cal=11,ALK=180

14. Serum electrophoresis

15. Immunoelectrophoresis

16. Myeloma Kidney Disease  Cast nephropathy  Hypercalcemia  Urate nephropathy  Drug and contrast nephropathy  Light chain deposition disease  Glumerolopathy  Amyloidosis

17. Myeloma Kidney Disease :

22. MGUS  M Protein < 3 gr/dl  Bone Marrow Plasma cell < 10%  No end organ damage

24. Hyper viscosity syndrome  Loss of vision  CNS symptoms  Hemorrhagic diathesis  Heart failure  Retina changes  Coma

31. Amyloidosis