RT Journal
A1 Fabricant, Peter D.
A1 Unnanuntana, Aasis
A1 Hartman, Barry J.
A1 Lane, Joseph M.
T1 Multifocal Osteomyelitis with Streptococcus pneumoniae in a Patient with Waldenström MacroglobulinemiaA Case Report
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2011
FD May 4
VO 93
IS 9
SP e46 1
OP 5
DO 10.2106/JBJS.J.00695
UL http://dx.doi.org/10.2106/JBJS.J.00695
AB 
Waldenström macroglobulinemia is a rare hematologic disorder in which a neoplastic clonal proliferation of terminally differentiated B lymphocytes produces excessive immunoglobulin M (IgM)1,2. This condition typically presents with constitutional symptoms including generalized fatigue and weakness, weight loss, and mucosal bleeding3. The known complications of this disorder, first described in 19444, include hyperviscosity, conversion to non-Hodgkin lymphoma, anemia, and hypofibrinogenemia1,2. Additionally, monoclonal proliferation of IgM leads to low concentrations of other immunoglobulins, such as IgG. This impaired antibody response5 renders patients vulnerable to encapsulated organisms such as Haemophilus influenzae type B, Neisseria meningitidis, and Streptococcus pneumoniae, as would be the case in an asplenic patient6.