ABSTRACT
Background: Plasma cell dyscrasia (PCD) is the term used to describe the disorders characterized by neoplastic proliferation of plasma cells with the abnormal production of immunoglobulins (Ig). Patients with multiple myeloma frequently have abnormal coagulation tests. Aim of the present study were to correlate prothrombin time (PT) and Activated Partial Thromboplastin time (aPTT) with Ig concentrations in patients with newly diagnosed with PCD and to compare PT and aPTT values in untreated and treated patients diagnosed with PCDMethods: This study was conducted in the department of clinical hematology of SKIMS, a tertiary care hospital in northern India from 2015 to 2016. Patients diagnosed with PCD were advised for coagulogram (PT, aPTT) as a base line investigation. A total of 72 patients were included in the study.Results: 37% of multiple myeloma cases (newly diagnosed) and 22% of light chain disease patients presented with prolonged PT whereas none of the patients in treated cases of PCD had prolonged PT. The mean Ig concentration was significantly higher in patients with prolonged PT and aPTT compared to that of patients with normal PT and aPTT values. In IgA myeloma, the mean immunoglobulin concentration was 3643 mg/dL with a mean PT and aPTT values of 18.8s and 36.6 (p value: 0.006). The mean free light chain concentration in kappa (k) light chain myeloma was 1727 mg/L with a mean PT value of 20.5 s, mean aPTT value of 37.4 s (p-value: 0.026).Conclusions: Patients with newly diagnosed myeloma presented with prolonged PT as compared to the treated cases. Also, mean Ig concentration was significantly higher in patients with prolonged PT and aPTT compared to that of patients with normal PT and aPTT values.
ABSTRACT
Background: When one or more extra X chromosome is added to a normal male karyotype (46-XY), then a new aneuploidy appears called Klinefelter Syndrome (KS). Every day approximately more than 50 new such cases are added in the male population of India. Traditionally they are lean, thin, tall, azoospermic, hypogonadic, infertile males with low social and educational profile. As the age advances level of testosterone decreases and many new symptoms of multiple systemic disorders appear in these cases. Methods: A well designed questionnaire of infertile males attending the above- mentioned OPD’s was filled with history, clinical examination and semen analysis (twice as per the WHO criteria). Results: In our series of 500 azoospermic males, we encountered 56 classical KS cases (11.2 %) of 47-XXY karyotype, who were hypergonadotrophic hypogonadic and diagnosed with multiple diseases when evaluated in detail. Conclusions: Hence, every KS must receive androgen replacement therapy, which should begin at puberty and continue for lifelong that helps in preventing the development of high comorbidity rate and premature deaths because these are very high in such condition as compared to normal male population.