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)

Patients with multiple myeloma excrete immunoglobulin light chain (Bence-Jones protein) in the urine. Light chain accumulates in the nephron, and this may result in renal disease, which accounts for the death of between 1 in 4 and 1 in 7 patients with multiple myeloma. Myeloma light chain inhibits transport of paraaminohippurate in the kidney. Evidence is presented here that light chain affects renal transport by inhibiting the active-transport enzyme, ouabain-sensitive Na-K-A.T.P.ase. As a direct consequence, renal A.T.P. content and the maximum rate of gluconeogenesis from lactate are enhanced in the presence of light chain.
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PMID:Inhibition of active-transport sodium-potassium-A.T.P.ase by myeloma protein. 7 13

One hundred consecutive patients with an ESR of 100 mm or more in the first hour admitted to a general medical unit were studied. Their mean age was 67 years and forty-seven were male. Three patients recovered without a satisfactory diagnosis. In thirty-three of the remainder a single diagnosis was considered responsible for the elevation of the ESR, and in the others multiple diagnoses were found. Infection was found in 60% of patients, malignancy in 28% (including 7% with myelomatosis), rheumatoid disease in 20% and renal disease in 11%. 34% of patients died within 6 months of entry into the study. In the absence of rheumatoid disease or a paraproteinaemia, elevation of the ESR in excess of 60 mm in the first hour at 1 month or longer was associated with a particularly poor prognosis. This study has shown the diagnostic implications of an ESR of 100 mm or more in the first hour and the prognostic significance of a persistent elevation of the ESR.
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PMID:The significance of gross elevations of the erythrocyte sedimentation rate in a general medical unit. 11 19

The authors describe a case which demonstrates that nephrotic syndromes occuring during the course of a myeloma are not always of the amyloid type. They emphasize the possibility of a dysglobulinemia being involved in a glomerular nephropathy syndrome, especially when there are histological lesions of a glomerulosclerosis. The published literature is reviewed and the possible pathogenesis of these nephropathies briefly discussed: either protein deposits, the nature of which has not been fully determined, or mesangial modifications induced by the filtered light chains.
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PMID:[Non-amyloid nephrotic syndrome: first isolated manifestation of a kappa light chain myeloma (author's transl)]. 12 16

The investigation covers the necropsic material of the Pathological Anatomy Chair, Medical Academy-Sofia, with a total of 3519 necropsies for a period of 5 years (1968--1970). In that material, 285 cases with uremia were established, due to chronic renal diseases, which might be referred to 13 nozological entities. The highest number of cases are with chronic pyelonephritis (64,96 per cent). The chronic glomerulonephritis, though it ranks second, is considerably rarely met (9,47 per cent). Endemic nephropathy, according to the incidence, follows--4,21 per cent, nephropathy in diabetes mellitus--3,86 per cent, subacute glomerulonephritis--3,16 per cent, amyloidosis--2,81 per cent, hypertonic disease--2,81 per cent, malignant tumors of the kidneys--2,81 per cent cystic kidneys--2,10 per cent, lupus erythematosus--1,05 per cent, sclerodermia--0,70 per cent, myeloma disease--0,70 per cent and polyarteriitis nodosa--0,35 per cent. As to the chronic renal disease, most frequently met in the material discussed, the chronic pyelonephritis, the authors discuss the factors that played certain role in its development as well.
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PMID:[Mortality due to uremia resulting from chronic kidney diseases]. 24 19

SLL's were tested by turbidometric assay on 33 male patients with multiple myeloma with three to 58 tests (mean 11) for each patient over a 7-year period. The age of the patients ranged from 31 to 83 years, with a median age of 58 years. SLL's in the normal controls were 14.4 +/- 3.5 microgram/ml. Patients with myeloma had a median lysozyme level of 16 microgram/ml and mean of 16.5. The SLL's in patients with lgG1,2,3,4, Iga, and kappa and lambda light-chain myeloma were similar. Slightly higher mean SLL'S were noted in older patients. Patients with severe renal disease also had higher SLL'S. No significant changes in SLL's were seen during infections or during mild granulocytopenia (granulocyte count greater than 500 cells/mm3). In severe granulocytopenia (granulocyte count less than 500 cells/mm3) the SLL's decreased and returned to normal levels when the white blood cell counts improved. In eight patients surviving for more than 5 years, the SLL's were not different from those of the other patients. SLL values in patients with multiple myeloma did not differ significantly by statistical test from those of controls when those patients with impaired renal function are excluded.
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PMID:Serum lysozyme in multiple myeloma. 40 95

A myeloma nephropathy in the rarely found paraproteinemia, class IgD is described for the first time in our country, manifested clinically from the very onset of the disease and advancing with a series of peculiarities, causing differential-diagnostic difficulties. The cytostatic treatment applied was with a good effect.
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PMID:[Nephropathy in a patient with IgD-myeloma]. 43 57

Three electrophoretic techniques are usually available in the clinical laboratories for the qualitative investigation of urinary protein patterns: 1) acetate cellulose, 2) immuno-electrophoresis; and 3) SDS-polyacrylamide gel electrophoresis. Proteinuria (the excretion of proteins in excess of 150 mg/day or 100 microgram/min) usually signifies either increased permeability of the glomerular-capillary membrane of diminished tubular reabsorption. Since glomerular disease is associated with an increased clearance of albumin and higher molecular weight proteins, whereas tubular damage is associated with the predominant excretion of proteins of lower molecular weight than albumin, it seems logical to establish a classification of proteinuria according to the molecular weight of its constituents. One can thus basically distinguish 5 types of proteinurias: 1) physiological; 2) tubular; 3) selective glomerular; 4) non selective glomerular; and 5) mixed proteinurias. Additionally one must distinguish "myeloma proteinurias" where monoclonal complete or incomplete gamma-globulins are found in the urine. Clinically it may be useful to determine the qualitatively normal or pathologic character of a quantitatively normal proteinuria, especially in the following conditions: 1) for early diagnosis of nephropathy in patients, such as diabetics, which are particularly prone to suffer from renal complications; 2) to confirm the clinical cure or to predict the recurrence of renal diseases; and 3) in such situations as orthostatic, or myeloma proteinuria, or any elevation of the urinary protein output of unknown etiology.
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PMID:Clinical relevance of different electrophoretic methods for the analysis of urinary proteins. 44 73

Alterations in affinity of amyloid for Congo red after incubation of tissue sections with potassium permanganate, as described by Wright el al, were studied. The affinity of amyloid for Congo red after incubation with potassium permanganate did not change in patients with myeloma-associated amyloidosis, familial amyloidotic polyneuropathy, medullary carcinoma of the thyroid, pancreatic island amyloid, and cerebral amyloidosis. Affinity for Congo red was lost after incubation with potassium permanganate in tissue sections from patients with secondary amyloidosis and amyloidosis complicating familial Mediterranean fever (consisting of amyloid AA). Patients with primary amyloidosis could be divided into two groups, one with potassium-permanganate--sensitive and one with potassium-permanganate--resistant amyloid deposits. These two groups correlated with the clinical classification in typical organ distribution (presenting with nephropathy) and atypical organ distribution (presenting with cardiomyopathy, nephropathy, and glossopathy) and the expected presence of amyloid AA or amyloid AL. Potassium permanganate sensitivity seems to be restricted to amyloid AA. The potassium permanganate method can be important in dividing the major forms of generalized amyloidosis in AA amyloid and non-AA amyloid. This can be used for differentiating early stages of the disease and cases otherwise difficult to classify. It is important to define patient groups properly, especially in evaluating the effect of therapeutic measures. (Am J Pathol 97:43--58, 1979).
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PMID:The potassium permanganate method. A reliable method for differentiating amyloid AA from other forms of amyloid in routine laboratory practice. 49 95

Fourteen cases of acute renal failure secondary to administration of radiographic contrast media were observed, eight within a 15-month period. No patient had multiple myeloma, and only three were diabetic. Predisposing factors included renal hypoperfusion, preexisting renal insufficiency, hyperuricemia, age of more than 60 years, solitary functioning kidney, and exposure to several contrast studies at closely spaced intervals. Control of blood volume and serum uric acid, appropriate spacing of radiographic studies, and possibly urinary alkalinization and hypouricosuric drugs in high-risk patients are recommended to decrease the incidence and morbidity of contrast-mediated nephropathy.
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PMID:Acute renal failure. Association with administration of radiographic contrast material. 57 72

This paper describes the detection of a paraprotein in blood or urine in 12 of 260 patients with 'idiopathic' proteinuria, most of whom presented with the nephrotic syndrome. None had myeloma at presentation and only two have developed it. Initial clinical and biochemical findings did not suggest paraprotein-associated disease, total serum globulins and individual immunoglobulin levels usually being in the normal range. In seven of the 12 cases the paraprotein was detected only after repeated analysis of serum and urine specimens over months or years. Renal histopathology varied from case to case and is described in detail; amyloid deposition did not occur in patients who excreted kappa chain Bence Jones protein and was extensive in only three. One of these eventually developed myeloma. Patients were aged 27--69 years at onset and were observed without specific therapy for up to 56 months. Glomerular filtration rate tended to decline and proteinuria persisted. All patients have now been treated by a chemotherapeutic regimen consisting of 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU), cyclophosphamide, melphalan, and prednisolone, in repeated short courses. In some patients, particularly those who had kappa Bence Jones protein, there was striking improvement. Overall survival is good, eight patients being alive 17--90 months after the onset of symptoms. The importance of repeated search for paraprotein in apparently idiopathic renal disease in adults is emphasized.
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PMID:Detection, significance and treatment of paraprotein in patients presenting with 'idiopathic' proteinuria without myeloma. 68 53


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