“I Have Macroglobulinemia, and Now What?”—Case Report

摘要

Waldenstrom macroglobulinemia (WM) is a chronic, indolent, lymphoproliferative disease of B lymphocytes, characterized by a lymphoplasmocytic lymphoma in the bone marrow and by Immunoglobulin (Ig) M monoclonal hypergammaglobulinemia. WM is considered incurable and the treatment of asymptomatic patients didn’t show benefit in terms of mortality. In this article, the authors present a case report of a 64-years-old woman, without relevant pathological history and asymptomatic, that resorted to a consultation on her Family Health Unit to show the results of a blood analytical study that was requested in a private medical routine consultation. In this study, erythrocyte sedimentation rate (ESR) had a value of 89 mm/h. One month later, ESR remained elevated, 94 mm/h. The further study revealed IgM monoclonal hypergammaglobulinemia of 26 g/L. The patient was sent for additional evaluation in the Haematology Service of the Hospital from the home area. In the course of the study, the patient showed increased anxiety and depressed mood due to the absence of a specific diagnosis. Finally, the diagnosis of WM was established, but, in the absence of symptoms related to the disease, no treatment was offered. The patient remained anxious, depressed and reluctant in accepting the diagnosis of a chronic disease without proper treatment. Therefore, the Family Physician has an essential role not only in choosing the most appropriate complementary diagnostic exams for their patients, but also in dealing with abnormal results of these exams. It’s crucial to protect patients from unnecessary exams or other health interventions. Sometimes, some diseases don’t have a proper treatment, requiring more effort in clarifying and monitoring these cases.