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Query: UMLS:C0026764 (multiple myeloma)
 36,148 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The case of a multiple myeloma secreting IgG kappa in both mother and daughter is reported and discussed in the light of previous reports of familial myeloma and myeloma occurring in spouses. In March 1981, the 60-year-old daughter complained of fatigue leading to the discovery of anemia. The diagnosis of myeloma was based on the association of a monoclonal IgG kappa (57.5 g/l) with low serum levels of IgM and IgA and of an increase (38%) in bone marrow plasma cells. She was treated by chemotherapy and by radiotherapy on bone lesions which appeared during the course of treatment. She died in June 1983. In October 1984, the 84-year-old mother was also found to have anemia. The diagnosis of myeloma was based on the association of a monoclonal IgG kappa (24.5 g/l) with low serum levels of IgM and IgA, 0.6 g/l of Bence-Jones protein in urine, an increase (12%) of atypical plasma cells, and of multiple lytic lesions on X-ray. Familial myeloma has been exceptionally reported. We have found only one case in mother and daughter where the myeloma protein was respectively IgA and IgG. The light chain isotype was not determined. Cases of myeloma occurring in spouses have equally been rarely reported in the medical literature. Genetic transmission of chromosomal determinants for myeloma or a type of response to environmental factors have been suspected as well as environmental determinants for myeloma. Genetically abnormal regulation of immunoglobulin synthesis is another possibility.
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PMID:[Familial IgG kappa myeloma in a mother and her daughter. Review of the literature]. 308 36

Intraarterial digital subtraction arteriography (DSA) was performed in a 39-year-old man with multiple myeloma, high-output congestive heart failure unresponsive to correction of anemia, and a pelvic bruit suspicious for an arteriovenous malformation. DSA revealed extensive neovascularity of all the visualized skeletal structures with rapid arteriovenous shunting in the pelvis. Temporary embolization of both hypogastric arteries with Gelfoam and autologous clot produced immediate and dramatic clinical relief of the shortness of breath, orthopnea, and hyperdynamic circulation. Following return of symptoms, repeat permanent occlusion with Ivalon and Gianturco coils produced minimal clinical response, but a decrease in cardiac output from approximately 23 L/min to 19 L/min. The etiology of congestive heart failure in myeloma, the implications of the use of intraarterial DSA, and the arteriographic findings in myeloma are discussed.
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PMID:Transcatheter treatment of myelomatous AV shunting causing high-output failure. 309 55

We report a rare finding: IgM kappa and Bence Jones lambda double gammopathy in serum of a 80-year-old man with untreated symptomatic multiple myeloma. The unusual findings are confined to the laboratory studies demonstrating also a Bence Jones lambda proteinuria, high erythrocyte sedimentation rate (113 mm/h), and anemia. The synthesis of the different light chains seems to occur in separate cellular clones.
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PMID:Multiple myeloma with serum IgM kappa and Bence Jones lambda biclonal gammopathy. 309 15

A 9-year-old dog with a 2-month history of weight loss and a 1-week history of blindness had an IgA-forming myeloma. Seemingly, the blindness was a result of bilaterally detached retinas. The dog also had leukopenia, anemia, hypoalbuminemia, hyperglobulinemia, and proteinuria as well as lytic lesions in the cervical portion of the spine and high IgA concentrations in serum and urine. Evaluation of aspirates from the subretinal spaces revealed lymphocytes in a proteinaceous fluid. Histologically, retinal lesions consisted of vascular endothelial cell damage and intraretinal cysts and hemorrhages.
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PMID:Blindness in a dog with IgA-forming myeloma. 318 88

In order to evaluate the diagnostic importance of the megakaryocytic morphology in the 5q- syndrome we studied the bone marrow from 48 unselected patients with myelodysplastic syndromes (MDS). 44 cases were primary and 4 secondary to cytostatic drug treatment or irradiation. There were 24 cases with chromosome anomalies, of whom 10 had del (5q). 4 of these had refractory anaemia (RA) with 5q- as the sole anomaly (group A), 2 had RA with 5q- and additional chromosome anomalies consisting of trisomy 8 (group B); 3 patients had RA with excess of blasts (RAEB) and complex, karyotypic changes also including 5q- (group B). Changes of the same type were found in 1 case of multiple myeloma with secondary MDS. All 6 RA patients with 5q- had characteristic megakaryocytes. More than 50% of the cells had no more than 2 nuclear segments, and predominantly had a diameter of 30 micron or more. No other patient with RA showed this picture. Only 1 patient with RAEB 5q- in group B had the same megakaryocytic changes. We conclude that diagnosis of a 5q- syndrome may be strongly suspected in cases of RA with these bone marrow changes. In cases of RAEB 5q- group B the bone marrow examination did not reveal the same consistent changes.
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PMID:Application of megakaryocytic morphology in diagnosing 5q- syndrome. 320 66

Extramedullary plasmacytoma (EMP), being different from multiple myeloma, is very rare. One case of primary EMP of small intestine and review of literature are presented. The patient, 69-year-old male, was admitted because of left lower abdominal pain and anemia. A mass, table-tennis in size, was palpated. Intestinal obstruction was found by plain X-ray film. It was diagnosed as EMP of small intestine by pathology after exploratory celiotomy. Immunohistochemical stain showed that intracytoplasmic immunoglobulin was monoclonal IgG. Lambda. The blood Bence-Jones protein and bone marrow puncture were negative. The patient received chemotherapy after operation and was followed for two years giving satisfactory result. The pathogenesis, clinical feature, diagnostic criteria and treatment are discussed.
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PMID:[Extramedullary plasmacytoma of small intestine--a case report]. 324 6

The relationship between presenting skeletal X-ray findings and survival in multiple myeloma was assessed in 172 consecutive patients treated at this institute. All patients were investigated, treated and followed up according to one protocol. The shortest survival was seen in those with normal X-rays (3-year actuarial 11 per cent) and the longest in those with minimal lytic changes (3-year actuarial 44 per cent). Patients with osteoporosis alone and those with extensive lytic lesions had intermediate survivals of 32 per cent and 33 per cent respectively. Of the other major prognostic features only anaemia demonstrated a significant correlation with X-ray findings in terms of survival (p less than 0.001) suggesting that those with normal X-rays may have a more diffuse marrow involvement accounting for their poor prognosis. The response on bone X-rays in 102 patients who completed nine cycles of chemotherapy was also analysed. Patients with evidence of healing had a 3-year actuarial survival of 37 per cent, those with progression 36 per cent and those with stable X-rays 65 per cent (p less than 0.01). Normal bone X-rays at presentation and radiological evidence of healing following therapy appear to be bad prognostic signs in multiple myeloma.
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PMID:The prognostic significance of X-ray changes at presentation and reassessment in patients with multiple myeloma. 334 25

A study of 75 myeloma patients diagnosed at the Kenyatta National Hospital, Nairobi, is presented. The male to female ratio was 1.7:1; the mean age +/- s.d. was 51.5 +/- 12.5 (range 16-80) years; the peak age incidence of 32% occurred in the sixth decade. A combination of: anaemia (81.3%), osteolytic lesions on X-ray skeletal survey (80%), bone pains (66.7%) and an ESR above 50mm/hr (77.3%) formed an important diagnostic tetrad. Other significant findings included: hypoalbuminaemia (76%), elevated leukocyte alkaline phosphatase (61.3%), uraemia (54.7%), upper respiratory tract infections (44%), elevated serum creatinine (34.7%), raised alkaline phosphatase (33.3%), pathological fractures (32%), hyperuricaemia (30.7%) and hypercalcaemia (29.3). The study confirms that the disease is not infrequent in indigenous Kenyan Africans as previous literature seemed to suggest. Poor prognosis was significantly (p less than 0.05) associated with hypoalbuminaemia, raised serum blood urea, hyperuricaemia and an elevated serum creatinine level.
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PMID:Pattern of multiple myeloma in Kenyans. 338 12

Clinical, hematologic, and immunologic findings for 14 dogs with Ehrlichia canis monoclonal gammopathy were studied retrospectively. Epistaxis, anemia, thrombocytopenia, hypoalbuminemia, hypergammaglobulinemia, and proteinuria were documented in the majority of these dogs. The serum protein electrophoresis pattern was characterized by a distinct narrow-base monoclonal spike, by a broad-base monoclonal spike, or by a monoclonal spike superimposed on a polyclonal gammopathy. The monoclonal spike disappeared following tetracycline treatment for ehrlichiosis. The long-term prognosis following treatment was generally good. The diagnostic features of monoclonal gammopathy due to myeloma were compared with those of E. canis monoclonal gammopathy. Owing to numerous similarities in clinical, hematologic, and immunologic findings, we conclude that an E. canis antibody titer should be determined in all dogs in which a diagnosis of benign monoclonal gammopathy is contemplated or definitive evidence of myeloma, leukemia, or macroglobulinemia is lacking.
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PMID:Monoclonal gammopathy associated with naturally occurring canine ehrlichiosis. 350 17

Diagnosis of multiple myeloma is based on the triad paraproteinemia, osteolytic bone lesions and bone marrow plasma cell infiltration. Clinically, rheumatoid-like pain induced by osteolytic skeletal lesions often prevails. Occasionally, foudroyant bacterial infections - the most frequent cause of death in myelomatosis - or acute/subacute renal failure or rarely, acute hemi- or paraparesis precede diagnosis. Establishment of diagnosis early in the course of the disease and improved cytostatic and symptomatic treatment has led to a decrease in episodes of hyperviscosity-syndromes. Severe renal insufficiency due to Bence-Jones proteinuria prevails in 20% of patients already at time of diagnosis. With increasing duration of the disease, frequency of renal insufficiency further increases. Hypercalcemia with consecutive dehydration and renal insufficiency usually is a complication of long-standing disease. Anemia, leukopenia and thrombo-cytopenia are not only side effects of cytostatic treatment, but also consequences of tumor-induced suppression of hematopoiesis. Polyneuropathies are common in myelomatosis. They probably are the result of specific and/or unspecific binding of paraproteins to myelin sheaths. Effective treatment for this complication is not available at present. Thrombohemorrhagic complications are more frequent in patients with myeloma than in the control group of other hospitalized patients. Non-secretory myeloma, osteoblastic myeloma and Takatsuki syndrome are variants of myelomatosis. Solitary and extramedullary plasmocytoma are different, potentially curable entities. Prognosis is especially poor in patients with plasma cell leukemia and poor in primary amyloidosis.
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PMID:[The clinical picture of multiple myeloma]. 353 47


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