What are the most common symptoms of Waldenstrom’s macroglobulinemia?

Waldenstrom’s macroglobulinemia (WM) is slow growing and may not cause signs and symptoms for many years. One in four people (25 percent) are asymptomatic – meaning without symptoms – when they are diagnosed. Often doctors discover WM when a person has blood tests done for some other reason.

Even after diagnosis you may not be symptomatic for many years. The most common early symptoms of WM are weakness and fatigue due to anemia. Anemia is a condition in which you lack enough red blood cells to carry adequate oxygen to your body’s organs. Other common symptoms of WM typically include:

Shortness of breath
Loss of appetite and weight loss
Fever, night sweats: Similar to other lymphomas, WM can cause fevers, even when you don’t have an infection, and drenching night sweats.
Numbness or tingling (a “pins and needles” sensation) in your hands or feet. This is a condition called peripheral neuropathy.
Swollen lymph nodes: You may feel little lumps under the skin around your neck, groin or armpits.
Swollen abdomen: This can be due to an enlarged spleen or liver, making your abdomen look swollen.

What are the complications of Waldenstrom’s macroglobulinemia

There are several complications of WM that can happen to some people and may cause symptoms. These complications include:

Hyperviscosity syndrome: With WM, your body produces abnormally high levels of the antibody IgM. Having high levels of IgM in your blood makes it thick – or viscous – impairing blood flow, especially through small blood vessels.

Doctors can monitor the thickness of your blood by doing a blood test called a blood (or serum) viscosity test. Typically, symptoms of hyperviscosity syndrome do not develop unless a person’s viscosity level is significantly elevated. However, this can vary considerably from person to person. Some of the more common symptoms of hyperviscosity syndrome are:

Headache
Dizziness
Confusion
Bleeding from the nose and gums
Changes in vision, such as blurriness, double-vision or blind spots

Cold agglutinin disease: Some people with WM have abnormal antibodies that react to cold temperatures. About 10 percent of people with WM have a particular type of cold-sensitive antibody in their blood that causes red blood cells to clump together (agglutinate) at low temperatures, and be destroyed by the body. This can lead to a condition called hemolytic anemia, where your red blood cells are destroyed faster than they’re made. Symptoms of cold agglutinin disease may include:

Dark urine
Fatigue
Shortness of breath
Jaundice (yellow skin and eyes)
Painful fingers and toes when exposed to the cold

Cryoglobulinemia: Cryoglobulins are another type of cold-sensitive antibody that some people with WM may have. When your body temperature drops below normal, cryoglobulins form gel-like clumps that block blood flow, particularly in areas exposed directly to the cold like your fingertips, ears and nose. Cryoglobulinemia can cause symptoms such as:

Blueness and/or pain of your hands or feet in cold temperatures
Purplish or red-brown skin lesions (called purpura)
Skin ulcers and gangrene
Swollen ankles and legs
Joint pain

Amyloidosis: This is a group of rare diseases that happens when an abnormal protein, called amyloid, builds up in your organs and interferes with their normal function. Many different proteins can lead to amyloid deposits, but only a few have been linked to major health problems. The type of protein and where it collects indicates the type of amyloidosis you have.

Amyloid deposits may collect throughout your body or in just one area. Organs that may be affected include your heart, kidneys, liver, spleen, nervous system and digestive tract. Symptoms of amyloidosis may include: