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- W2727889378 abstract "A 62-year-old, well-appearing gentleman of Middle Eastern descent presented to his primary care physician with persistent back pain. Per patient report, the pain began 8 months prior and had been steadily worsening. No trauma or inciting incident was identified. No weight loss or fatigue was endorsed. Routine chemistry and hematology laboratory values were all within normal limits, although a low-normal total protein was noted (Table 1). Serum protein electrophoresis and immunofixation were ordered and read as normal (Fig. 1). In the absence of remarkable laboratory findings, the patient was referred to radiology for imaging studies. A skeletal survey and a computed tomography (CT)2 were performed; CT revealed the presence of an osteolytic lesion at the L4 level. A thorough laboratory workup was thus conducted, which included serum free light chains (sFLC; Freelite®, The Binding Site); the results showed an increased free κ (2.60; 0.33–1.94 mg/dL) with a concomitant increased κ/λ ratio (2.22; 0.26–1.65). A 24-h urine sample was also ordered, but no detectable Bence Jones protein was found by means of electrophoresis or immunofixation. On the basis of these findings, the clinical differential diagnosis included metastatic disease, multiple myeloma, or an infectious process (i.e., osteomyelitis). The patient had no history of cancer and no symptoms to suggest infection; …" @default.
- W2727889378 created "2017-07-14" @default.
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- W2727889378 date "2017-07-06" @default.
- W2727889378 modified "2023-09-26" @default.
- W2727889378 title "Persistent Back Pain and Normal Serum Immunofixation in an Older Gentleman" @default.
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- W2727889378 doi "https://doi.org/10.1373/jalm.2016.022277" @default.
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