BOF: 33
A 69-year-old male who is known
to have ulcerative colitis has been found to be mildly anaemic and has a high
ESR.
His colitis is quiescent with a
normal bowel habit and his last surveillance colonoscopy was normal. He is not
jaundiced nor does he have fever.
There are no abnormalities
found on clinical examination.
Investigations reveal:
Hb 11.5 g/L
WCC 4.7
PLT 168
Corrected Calcium 2.60
IgG 26 (6-13)
IgA 1.6(0.9-3)
IgM 1.5 (0.4-2.2)
Which of the following
investigation would you arrange next?
a)
Colonoscopy
b)
Magnetic Resonance Cholangio Pancreatography
c)
Isotope bone scan
d)
Plasma protein electrophoresis
e)
Chest x-ray
Answer:
d)
The patient has quiescent
ulcerative colitis and does not appear to have any complication in relation to
this. In an elderly patient with an elevated ESR, elevated calcium,
immunoglobulins and mild anaemia one would consider a diagnosis of multiple
myeloma and hence plasma protein electrophoresis would be the investigation of
choice.
Last Updated: 16/04/06
