#16
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çíà÷èò, åòè èçìåíåíèÿ çà ñ÷åò èììóíîãëîáóëèíà Ì, íóæíî ðàçáèðàòüñÿ ìîíîêëîíàëüíîå èëè ïîëèêëîíàëüíîå åãî óâåëè÷åíèå, ïîñëå ÷åãî èñêëþ÷àòü ñïåêòð òåõ èëè èíûõ áîëåçíåé
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#17
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Öèòàòà:
Èëè âîò ýòè àíàëèçû "Àíòèíóêëåàðíûå (àíòèÿäåðíûå) àíòèòåëà IgG" è "Àíòèòåëà IgG ê ìèòîõîíäðèÿì" èç ýòîé îïåðû? |
#18
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êîãäà èäåò åëåêòðîôîðåç ïðîòåèíîâ, òî èìååòñÿ èëè îäíà æèðíàÿ ïîëîñà (ìîíîêëîí. áåëîê) èëè äèôôóçíîå çàòåìíåíèå (ïîëèêëîí. áåëîê) âèçóàëüíàÿ îöåíêà äåíñèòîãðàììû - âñå ÷òî íóæíî
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#19
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#20
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âñå êàê è ïðåäïîëàãàëîñü - èììóíîãëîáóëèí Ì ïîâûøåí èç-çà ìîíîêëîíàëüíîãî êîìïîíåíòà; íóæíà êîíñóëüòàöèÿ î÷íîãî ñïåöèàëèñòà äëÿ óñòàíîâëåíèÿ äèàãíîçà/ïðè÷èí åòîãî
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#21
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#22
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ïîêà íåò - ïîñåøåíèå î÷íîãî ãåìàòîëîãà è èñêëþ÷åíèå ìèåëîìû è äð. ðåëåâ. áîëåçíåé, òîãäà îñòàíåòñÿ íàáëþäàòü çà ìîíîêëîí. ãàììàïàòèåé
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
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#23
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#24
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êàê ïðàâèëî, äëÿ èñêëþ÷åíèÿ èìåííî ìèåëîìû áèîïñèÿ êì òðåáóåòñÿ, äëÿ ïîñòàíîâêè èíûõ ãåì. çàáîëåâàíèé, ñîïðîâîæä. ïîäüåìîì ìîíîêëîíà, íå âñåãäà îáÿçàòåëüíà
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#25
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Öèòàòà:
Ðåíòãåí ÿ ñäåëàë - "Ïîëîæåíèå, ôîðìà è ñòðóêòóðà êîñòåé ÷åðåïà íå èçìåíåíû". ÎÀÊ ïîêà íå ïåðåñäàë. ÎÀÌ òîæå, íî â ïðîøëîì àíàëèçå áåëêà íåò, ñîîòâåòñòâåííî è Áåíñ-Äæîíñà èññëåäîâàòü íåîòêóäà. À âîò ïóíêöèþ äåëàòü áîþñü. Ìîæåò êàêèå-òî åù¸ äðóãèå àíàëèçû åñòü äëÿ óòî÷íåíèÿ äèàãíîçà íå ïðèáåãàÿ ê ïóíêöèè? |
#26
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ïîõîæå, íåò:
Monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM) are asymptomatic, pre-malignant disorders characterized by monoclonal plasma cell proliferation in the bone marrow and absence of end-organ damage. MGUS is defined by the presence of a serum monoclonal (M) protein < 3 g/dL, bone marrow plasma cells < 10%, and absence of anemia, hypercalcemia, lytic bone lesions, or renal failure attributable to the plasma cell proliferative disorder. The diagnosis of SMM requires a serum M protein ≥ 3 g/dL or bone marrow plasma cells ≥ 10%, plus absence of anemia, hypercalcemia, lytic bone lesions, or renal failure attributable to the plasma cell proliferative disorder.
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#27
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 ñìûñëå - ïóíêöèþ äåëàòü îäíîçíà÷íî?
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#28
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íå ïîéìó âàøåãî ñòðåìëåíèÿ ê àâòîöèòèðîâàíèþ ñîîáùåíèé - ïðî÷òèòå âíèìàòåëüíî ïðàâèëà ôîðóìà åùå ðàçîê; ñêàæèòå, ÷òî Âàì ñòàëî ïîíÿòíî, ïîñëå ïðî÷òåíèÿ ïåðåâîäà èíôîðìàöèè âûøå? åñëè ïîäîçðåâàåòñÿ èíîå çàáîëåâàíèå, êîòîðîå ñîïðîâ. ïîâûøåíèåì ìîíîêëîíà Èãì (íàïðèìåð ëèìôîìà, íåãåìàò. îïóõîëü èëè ìàêðîãëîáóëèíåìèÿ), òî â ïóíêöèè ÊÌ íè÷åãî äèàãíè÷åñêîãî íåò, ëþáîé âìåíÿåìûé î÷íûé ãåìàòîëîã ðàññêàæåò Âàì àëãîðèòì îáñëåäîâàíèÿ ïðè âûÿâëåíèè ìîíîêëîíà, Âàøà çàäà÷à íàéòè òàêîãî, äàæå åñëè ïðèäåòñÿ âûåõàòü çà ïðåäåëû ãîðîäà èëè ñòðàíû, äàëüíåéøåå çàî÷íîå êîíñóëüòèðîâàíèå áåññìûñëåííî.
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#29
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Ñïàñèáî
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