Why does patients with multiple myeloma have increased albumin level?

[by_stander22, LPN]

Thank you!

[Daytonite, BSN, RN]

why do patients with multiple myeloma have increased albumin levels?

http://myeloma.org/pdfs/cr07-eng_c2_web.pdf

- "multiple myeloma: cancer of the bone marrow, concise review of the disease and treatment options" - this pamphlet from the international myeloma foundation says this about its pathophysiology:

"infections

- the predisposition to infections is perhaps the single most characteristic feature of myeloma patients besides the strong tendency for bone disease. the mechanisms responsible for infection susceptibility are not fully understood. the presence of active myeloma in the bone marrow results in impairment of normal immune functions, including normal antibody production (reflected by

hypogammaglobulinemia

), impaired t-lymphocyte function, and activated but aberrant monocyte/macrophage function. some studies indicate that a factor issuing from the activated macrophages both enhances the activity of the myeloma, and inhibits normal immunoglobulin production and t-lymphocyte functions."

• http://www.emedicine.com/med/topic1120.htm
  - hypogammaglobulinemia -states " renal loss of immunoglobulins is exemplified by nephrotic syndrome, in which igg loss is usually accompanied by albumin loss."

keep in mind that globulins are the building blocks of antibodies and that globulin and albumin together constitute most of the protein in our body. when there is infectious process going on, and the infections that occur when a person has a cancer such as multiple myeloma are huge and ongoing, the body's store of these building blocks is going to be depleted. now, i'm having difficulty finding the specific information, but it may be that while the globulins are being depleted, the albumin is not which would account for the specific rise in a serum albumin level. but i am just guessing. you do get big protein losses with mm and that is reflected by doing bence jones urine for protein. myelomas cause high levels of bence jones protein, a type of m-protein. the deciding factor might be that low molecular weight proteins are dumped through the kidneys while high molecular weight proteins get left behind and remain in the body longer. ????

http://www.cancer.gov/cancertopics/wyntk/myeloma - what you need to know about multiple myeloma

bence jones protein

• http://www.sas-centre.org/assays/protein_reference_units/bjp.html - bence jones protein
  
• http://www.nlm.nih.gov/medlineplus/ency/article/003597.htm - bence jones protein

[celclt]

the breakdown of bone (myeloma creates )releases calcium and phosphate into the blood stream- calcium binds to albumin- they have an almost directly proportionate relationship..this 'false' hypercalcemia (because ther are no ssxs of hypercalcemia, only elevated Ca level) causes RF as well...the tumor itself creates the B/J protein (immunoglobin) and they deposit in the kidney--Got this from my Tortora anatomy book-hth!