See: Egypt > Al-Arrayed et al., 1989.

Al-Arrayed et al. (1989) reported an Egyptian patient with Waldenstrom macroglobulinemia (WM) in Bahrain. The patient was 54 years old and was admitted to the medical center due to epistaxis, bleeding from the gums, weakness and tiredness, and excessive bruising of one month duration. Hemorrhagic patches were seen on the left arm and legs. Examination of the abdomen showed smooth non-tender liver enlargement and palpable spleen. Complete blood count results were: Hb 6.6 g/dl, WBC 9.4x 10power9 /L, RBC 2.09x 10power9 /L, HCT 20.9%, and platelets 107x 10power9 /L. The differential count showed 22% polymorphs, 62% lymphocytes, 7% monocytes, 1% promyelocytes, 2% myelocytes, 1% metamyelocytes, 1% blasts, and 2% atypical lymphocytes. The peripheral smear showed marked rouleaux formation. Bone marrow aspiration was hypercellular and showed a high proportion of small lymphocytes, plasmacytoid lymphocytes and plasma cells, some of which showed excessive cytoplasmic globules. The biochemical investigations revealed total proteins 12.5 g/dl, albumin 3.91g/dl, globulins Alpha1 (0.05), Alpha2 (0.28), beta2 (0.21) and (8.05) A/G ratio as 0:45. The serum electrophoresis showed a monoclonal M band of paraprotein. Immunoelectrophoresis revealed a specific IgM Kappa paraprotein band. IgM was 64 g/L. Sia water test was positive.

[Al-Arrayed A, Bhagwat GP, Chandra S. Waldenstrom's macroglobulinaemia: a case report. J Bahrain Med Soc. 1989; 1(2):77-9.]

Taleb et al (1991) described a Lebanese family in which two sisters were diagnosed with Waldenstrom macroglobulinemia. Fou other sisters were found to have asymptomatic polyclonal IgM hypergammaglobulinemia.