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

Investigation of the locomotor system of 20 patients is reported. One patient with arthrosis of the hip joint and concomitant osteonecroses had a myeloma. In 5 RA patients the manifestations of secondary amyloidosis are described. Among the patients with monoclonal gamma globulinemia two had polyarthritis and RA could not be excluded in one of them, one had arthritis of the ankle and foot joints, and one had a vasculitis characteristic of polyarteritis nodosa. Among those with polyclonal immunoglobulinemia one had RA, two had arthrosis of knees and hips, and two had ankylosing spondylitis. Furthermore four patients with alpha2-hyperglobulinemia which is important in evaluation of the alpha2-globulin peak in amyloidosis, are described. Three patients had cryoglobulinemia. In 10 patients hyperuricemia was found repeatedly (by the uricase method). Consequently in these diseases it is necessary to search clinically for crystal induced synovitides and arthropathies. The classification of globulinopathies and the method of their determination is indicated and particular investigations are recommended for such diseases, where the activity of the joint process does not correlate with laboratory findings.
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PMID:[Globulinopathy and hyperuricemia]. 89 99

The authors confirm the great rarity of joint complications in patients with Kahler's disease. Among the records of 1953 cases the following complications were the only one found: 2 cases of proved articular amylosis, 2 cases of probable articular amylosis, 3 cases of possible articular amylosis, 20 cases of arthropathy that were impossible to classify, 27 cases of compression of the median nerve in the carpan canal, 6 cases of gouty arthritis, and 3 cases of septic arthritis. The data on symptoms obtained in the course of this enquiry are in conformity with the data in the literature. Articular amylosis often takes on the appearance of a polyarthritic syndrome of progressive installation and extension, involving in particular the hands and the wrists, but sometimes involving in a symmetrical bilateral manner the elbows, the shoulders, and the knees. The affected joints are swollen, stiff, and painful. Local signs of inflammation are, however, often absent. The deformations characteristic of rheumatoid arthritis do not develop. The joints do not show radiological signs for most of the time. In addition, it is not possible to detect the rheumatoid factor in the serum. The arthropathies can also assume an oligo-articular topography. Articular discharges are very frequent: they are usually of a mechanical nature. Whatever the clinical appearance, an exact diagnosis can be established only by means of anatomo-pathological examination of the synovial membrane or of certain para-articular amyloid nodules. Myelomas complicated by amyloid articular deposits are often light chain, with only little increase in the erythrocyte sedimentation rate, discrete hyperproteinaemia, moderate medullary plasmocytosis, and rare or limited radiological lesions. The carpal canal syndrome is either isolated or included within the framework of a polyarthropathy. Compression of the median nerve is due to amyloid infiltration into the synovial sheath of the tendons of the finger flexors, proof of which is not always easy. Gout is rare despite the frequency of hyperuricacidaemia caused by renal insufficiency. Septic arthritis is often caused by renal insufficiency. Septic arthritis is often caused by pneumococci to which those with a myeloma appear particularly suceptible.
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PMID:[Articular complications of Kahler's disease. Results of a survey of 1953 cases of plasmocytic myelomas]. 112 74

In summary, a case of amyloid arthropathy of the left ankle in a 64-year-old patient with multiple myeloma is presented. The asymmetric presentation and site of deposition in the ankle were taken to be unusual. Involvement of both hips and the right shoulder was also suspected on subsequent evaluation. The patient's history and MR studies were essential in establishing the preoperative diagnosis. The extent of involvement, destruction of underlying cartilage, associated effusion and tenosynovitis were optimally defined by the MR images. The MR images also provided preoperative guidance in determining the approach and optimum site of biopsy.
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PMID:Case report 610: Amyloid arthropathy of the left ankle. 221 96

The authors describe a case of plasmocytic myeloma complicated by the development of systemic amyloidosis. The symptoms were dominated by marked macroglossia and arthropathy which by the objective finding and subjective manifestations imitated rheumatoid arthritis. In the discussion the authors emphasize general manifestations of amyloid arthropathy.
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PMID:[Amyloidosis in plasmacytic myeloma with dominant manifestations of joint involvement]. 274 85

Bone marrow scintigraphy was performed in 40 patients with haematological disorders (lymphomas, multiple myeloma, myeloid leukaemia, panmyelopathy and others). Routine skeletal scintigraphy was available for comparison in 18 patients. In agreement with the literature it became evident that marrow scintigraphy can show infiltrations of the bone marrow in haematological disorders earlier than skeletal scintigraphy. Hot lesions were caused by reactive proliferation of the bone marrow such as may occur with acute inflammatory joint diseases, osteomyelitis, fracture healing or other entities. Marrow imaging demonstrated reliably the actual distribution of the functioning bone marrow, a characteristic that is important for diagnosis and staging, especially in myeloproliferative diseases.
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PMID:[Results of bone marrow scintigraphy in hematological diseases]. 303 61

This is the first report of an autopsy case of systemic amyloid arthropathy associated with multiple myeloma in Japan. The patient was a 72-year-old male who had been suffering from multiple myeloma (IgA-lambda) with extensive arthropathy of the systemic joints. Autopsy examination revealed severe deposit of amyloid in the articular cavities of the systemic joints showing a feature of amyloidoma. Furthermore, numerous amyloid deposits were found in the wall of small blood vessels in the major organs. In the bone marrow, there were many atypical plasma cells and foamy cells both showing positive reaction for IgA and lambda light chain. No such atypical cells were observed in the other organs except for the bone marrow.
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PMID:Systemic amyloid arthropathy associated with multiple myeloma. 311 58

The clinical and laboratory findings in seven female patients with primary autoimmune diseases, one female patient with lymphoplasmacytoid (LP) immunocytoma and IgM paraproteinemia, and two male patients with multiple myeloma are described. The common denominator in all patients was a lupus anticoagulant or a closely related coagulation disorder. Recurrent thrombosis was observed in six patients with autoimmune diseases and in two patients with malignant monoclonal gammopathies. Other clinical manifestations included cerebral disorders (four patients with autoimmune disease/two patients with monoclonal gammopathy), repeated obstetric complications (6/1), asymptomatic valvular heart disease (6/1), renal dysfunction (6/2), hepatic involvement (2/2), and arthropathy (2/0). Laboratory investigations revealed a biologic false-positive serological test for syphilis in six patients with autoimmune disease and one with monoclonal gammopathy, antinuclear antibodies (4/0), antibodies against DNA (4/1), and a positive direct Coombs test (3/1) which was accompanied by hemolytic anemia in two patients (1/1). Additionally slight leukocytopenia (2/1) and thrombocytopenia (6/2) were observed; abnormal bleeding was only seen in one patient with severe thrombocytopenia. Other complications characteristic of LP immunocytoma or multiple myeloma were missing. The obvious similarities between the patients with autoimmune diseases and the patients with malignant monoclonal gammopathies suggest analogous pathogenetic mechanisms.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Lupus anticoagulant associated syndrome in benign and malignant systemic disease--analysis of ten observations. 311 94

The clinical picture of 15 patients (10 male, five female) with amyloid arthropathy secondary to chronic renal failure treated with haemodialysis has been studied. The average period of haemodialysis was 10.8 years. Joint symptoms appeared between three and 13 years after starting haemodialysis. No patient had renal amyloidosis. Early symptoms were varied and often overlapped: knee swelling (seven patients), painful and stiff shoulders (seven), and carpal tunnel syndrome (six) were the most prominent. Follow up showed extension to other joints. Joint effusions were generally of the non-inflammatory type. Radiologically, geodes and erosions of variable sizes were seen in the affected joints, which can develop into a destructive arthropathy. Amyloid was found in abdominal fat in three of the 12 patients on whom a needle aspiration was performed. Four of 12 patients showed changes compatible with amyloid infiltration in the echocardiogram. One patient had amyloid in the gastric muscular layer, another in the colon mucus, and two of four in rectal biopsy specimens. Amyloid deposits showed the presence of beta 2 microglobulin in 10 patients. The clinical and radiological picture was similar to the amyloid arthropathy associated with multiple myeloma. These patients can develop systemic amyloidosis.
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PMID:Clinical picture of the amyloid arthropathy in patients with chronic renal failure maintained on haemodialysis using cellulose membranes. 331 Sep 26

An autopsy case of multiple myeloma (IgA-lambda) with extensive amyloid arthropathy of the systemic joints was described. Heavy deposits of amyloid (amyloidoma) were observed in the articular cavities of the joints. Furthermore, numerous amyloid deposits were found in the walls of small blood vessels in the general organs. Incubation of the paraffin sections of amyloid with potassium permanganate produced little loss of Congo red affinity and apple-green birefringence under polarized light. A crude preparation of amyloid protein was isolated from a frozen intra-articular mass, which had been obtained at necropsy, and injected into the footpads of BALB/c mice with complete Freund's adjuvant. The immune spleen cells were fused with myeloma cells (P3 X 63-Ag8.653) under the presence of polyethylene glycol. Hybridoma cell lines, producing supernatants which reacted not only with amyloid substances but also with normal human tissues, were omitted from the subjects of recloning, and one hybridoma cell line (Am-1) producing a specific monoclonal antibody (MAb) against the immunized amyloid substance was finally obtained. Using the indirect immunoperoxidase method, the specificity of MAb Am-1 was confirmed in the cryostat sections as well as in the formalin-fixed paraffin sections of various organs of the case from which the crude amyloid protein was obtained and used for immunization. Amyloid deposits in 25 cases with amyloidosis or amyloid deposits were examined with MAb Am-1, and 2 cases showed positive reactivity with Am-1. These 2 cases presented primary amyloidosis and focal amyloid deposits in the oral cavity, respectively; Congo red staining of amyloid in these cases showed resistance to treatment with potassium permanganate, as observed in the amyloid of the original case used for immunization. Trypsin treatment of the sections resulted in a loss of positive reactivity with MAb Am-1 in all these cases. This result indicates that Am-1 recognizes a substance composed of protein molecules. Furthermore, the immunohistochemical distribution of Am-1 positive reaction was consistent with the histological distribution of substance which could be stained by Congo red and showed apple-green birefringence under polarized light. These results have suggested that Am-1 reacts with a portion of amyloid protein which is resistant to treatment with potassium permanganate followed by Congo red staining.
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PMID:Production of monoclonal antibody against amyloid fibril protein and its immunohistochemical application. 391 46

Amyloid arthropathy is said to be distinguished roentgenographically from rheumatoid arthritis by the absence of joint space narrowing and the absence of articular erosions. We present a patient with multiple myeloma with swelling, stiffness and firm synovial thickening of the wrists, metacarpophalangeal joints and proximal interphalangeal joints whose hand radiographs showed articular erosions of the carpal joints and ulnar styloid and joint space narrowing of the proximal interphalangeal joints and metacarpophalangeal joints. Synovial biopsy of the left wrist showed amyloid deposits with no inflammation. Previous reports of X-ray changes in amyloid arthropathy note preservation of joint spaces or widening. Erosions when noted are of non-articular bone rather than of the articular surface. This is the first case report of erosive articular disease in amyloid arthropathy.
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PMID:Erosive arthritis in a patient with amyloid arthropathy. 400 90


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