Pseudo-negative serum protein electrophoresis due to IgM aggregation in a patient with Waldenström macroglobulinemia: A case report.
Hanhan Xie, Enping He, Hui Quan et al.
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Case in brief
A 79-year-old male presented with 10 months of anemia and bilateral lower limb and testicular edema. Following serological testing, serum protein electrophoresis, and genetic analysis, he was diagnosed with Waldenström macroglobulinemia. Treatment included a red blood cell transfusion and zanubrutinib, leading to improvement in dizziness and fatigue, resolution of anemia, and no new blood blisters.
What made this case unusual
The case illustrates pseudo-negative serum protein electrophoresis results due to IgM aggregation, which can complicate the diagnosis of Waldenström macroglobulinemia.
Diagnostic / clinical pearl
Clinicians should consider Waldenström macroglobulinemia in elderly patients with refractory anemia, especially when faced with atypical electrophoresis results.
Why it matters
Understanding the potential for false-negative results in serum protein electrophoresis due to IgM aggregation is crucial for accurate diagnosis and management of patients with WM.