Case study biomedical science - Essay Example

Lower hemoglobin is generally observed due to reduction of RBC in blood stream. In bone morrow most of the hematopoietic cells are converted to plasma cells or the overall cellular growth diverted toward generation of plasma cell and reduction in other types of blood cells like RBC and WBC. Bone pain is another primary symptom of multiple myeloma since it occurs due to heavy infiltration of malignant plasma cell in to bone morrow. Infiltration of malignant plasma cells leads to excessive release of IL-6, IL-1 and TNF which helps in formation of osteoclast formation (responsible of bone resorption).

Excessive bone resorption leads to mineralization of bone matrix and one can observe elevated level of calcium in blood stream. For the confirmation of the above said condition, total calcium was analyzed form blood stream and it was found to be very high clearly indicates the condition. To avoid any confusion regarding observed symptoms and liver related disorders, enzyme detection pertaining to liver specific test was carried out like alkaline phosphatase. Alkaline phosphatase was found to be normal.

Similarly kidney specific test were carried out to detect any malfunctioning of kidney and elevated level of urea was determined along with elevated protein in serum. This observation clearly indicates impaired renal functioning, another sign of multiple myeloma. Total protein estimation from blood was considered to be key test for establishment of multiple myeloma in light of above mention tests. Here total protein in blood was found to be elevated along with reduction in total albumin which indirectly tells increase in globulin protein in blood.

Sixty percent of total protein found in blood is of albumin while rest is globulin and other proteins. The major function of albumin is to provide osmotic regulation and viscosity to blood and produced by liver while globulin has 4 fractions alpha1, 2, beta and gamma globulin, having key role as defense against infection. Increase in globulin and particularly gamma globulin indicates excessive plasma cell growth or infection. To confirm elevation of gamma globulin electrophoresis was used where one can differentiate different types of globulin and based on band intensity one can calculate relative abundance.

Protein electrophoresis is routine analytical technique to differentiate and identify proteins. Its work on principle of protein migration in Poly acrylamide gel under influence of potential difference provided across the gel. Protein molecules migrate in to gel based on Molecular weight, Higher the molecular weight lower the migration (distance travel by protein form positive electrode to nagative electrode) and vice versa. The electrophoresis results clearly indicate elevation of gamma globulin and hence antibody producing cells.

It was also observed that patient have recurrent infection and microbiological analysis shows infection of diplococci. In multiple myeloma recurrent infection is common as only particular group of plasma cell proliferate which reduced the diversity of antibody producing cells and hence reducing overall Immunity. For visual confirmation bone marrow smear was analyzed for investigating population of plasma cell and was found to be corroborate with previous observation. There was around