Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0026764 (multiple myeloma)
 36,148 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 57 year old female patient demonstrated subacute generalized cerebellar symptoms and the investigations which were done exhibited that the clinical picture was due to the remote effect of multiple myeloma. In this case of paraneoplastic cerebellar degeneration, MRI showed cerebellar vermian atrophy when the brain CT scan was negative. Diagnosis of multiple myeloma was possible only on about the 17th month of the illness when monoclonal gammapathy-IgG in serum of the patient and abnormal plasma cells of 13% in her bone marrow biopsy were exhibited. Bence-Jones proteinuria with kappa light chain was found in the 3.4th year of the illness. Paraneoplastic cerebellar degeneration disabled the patient in 3-4 months and remained as an irreversible process during the 3.4 years in which she was followed until her death. Chemotherapy for multiple myeloma did not affect the cerebellar syndrome.
 ...
PMID:Paraneoplastic cerebellar degeneration associated with multiple myeloma--3.4 years follow up. 221 16

Progressive multifocal leukoencephalopathy (PML) is an uncommon opportunistic infection with high morbidity and mortality. This is an institutional review board-approved retrospective review of medical records identified by diagnostic coding for PML or John Cunningham virus (JCV) from 2000 to 2015. Inclusion criteria were cerebrospinal fluid (CSF) positive for JCV by polymerase chain reaction or brain biopsy-proven PML in non-HIV patients. There were 16 patients, 12 of whom were men (75%); the median age was 56 years (range, 31-71 years). All had hematologic malignancies (5 [31%] had chronic lymphocytic leukemia, 3 [19%] had acute myeloid leukemia, 3 had [19%] mantle cell lymphoma, and 1 patient each had acute lymphoblastic leukemia, Hodgkin lymphoma, myeloma, or B-cell lymphoma). One patient received no cancer-directed therapy. Of the remaining 15 patients, all received conventional chemotherapy, and 9 (60%) underwent transplant. Thirteen patients (87%) received immunomodulating therapy (predominantly rituximab). The median time from cancer diagnosis to PML diagnosis was 48.5 months. PML was diagnosed a median of 2.1 months from symptom onset; however, the median time to PML diagnosis was 5.4 months for the 4 patients presenting with a cerebellar syndrome. PML was diagnosed by CSF in 12 patients and brain biopsy in 4 following negative CSF test results. Median survival from PML diagnosis was 4.3 months for the 11 patients on treatment and 0.87 months for the 5 without treatment. PML still occurs in patients with hematologic malignancies in the absence of treatment. Twenty-five percent of our patients required brain biopsy for diagnosis, and diagnosis was delayed when the clinical presentation was unusual, such as a cerebellar syndrome.
 ...
PMID:Progressive multifocal leukoencephalopathy and hematologic malignancies: a single cancer center retrospective review. 2929 50