30th September 2021
C.R.A.B is the acronym designed to simplify the most typical clinical manifestations of multiple myeloma. Clinicians should consider the following indicators in a potential myeloma diagnosis:
C: Calcium – hypercalcaemia
Symptoms include: excessive thirst, nausea, constipation, loss of appetite, and confusion.
R: Renal – any form of renal dysfunction
A: Anaemia (of unknown cause)
Symptoms include: exhaustion, weakness, mental fatigue, and forgetfulness.
B: Bone – unexplained and persistent bone pain (often back pain)
Symptoms include: pain, breaks/fractures, and spinal problems.
Helpful hint:
NICE NG12 guidelines advise that a very urgent protein electrophoresis and Bence-Jones protein urine test (within 48 hours) to assess for myeloma in people aged 60 and over with hypercalcaemia or leukopenia and a presentation that is consistent with possible myeloma.
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