Differential Diagnosis for Increased Plasma Cells in Bone Marrow with Fever
Single Most Likely Diagnosis
- Multiple Myeloma: Although less common in younger individuals, multiple myeloma is a consideration with increased plasma cells in the bone marrow. The presence of fever for a year could indicate an underlying malignancy, and multiple myeloma can present with a variety of systemic symptoms including fever.
Other Likely Diagnoses
- Chronic Infections (e.g., Endocarditis, Osteomyelitis): Chronic infections can lead to a prolonged febrile illness and may stimulate an increase in plasma cells as part of the immune response.
- Chronic Inflammatory Diseases (e.g., Rheumatoid Arthritis, Lupus): These conditions can cause an increase in plasma cells due to chronic inflammation and immune system activation.
- Monoclonal Gammopathy of Undetermined Significance (MGUS): This is a condition characterized by the presence of a monoclonal protein (M protein) in the blood, which can be associated with an increase in plasma cells in the bone marrow. It's more common in older adults but can occur in younger individuals.
Do Not Miss Diagnoses
- Lymphoma (especially Plasma Cell Lymphoma): Lymphomas can present with systemic symptoms like fever and may involve the bone marrow, leading to an increase in plasma cells.
- Plasma Cell Leukemia: A rare and aggressive form of leukemia that can present similarly to multiple myeloma but with a higher number of plasma cells circulating in the blood.
- Infectious Diseases (e.g., Tuberculosis, Brucellosis): Certain infectious diseases can cause prolonged fever and stimulate an increase in plasma cells. These conditions are critical to diagnose due to their treatability with specific antimicrobial therapies.
Rare Diagnoses
- POEMS Syndrome: A rare condition characterized by Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal gammopathy, and Skin changes. It can present with an increase in plasma cells in the bone marrow.
- Castleman Disease: A rare disorder that involves an overgrowth of cells in the body's lymph nodes, which can lead to an increase in plasma cells and systemic symptoms like fever.
- Heavy Chain Diseases: Rare conditions characterized by the production of abnormal heavy chains of immunoglobulins, which can lead to an increase in plasma cells in the bone marrow and various systemic symptoms.