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)

From March, 1976 to June, 1983, 22 patients (10 males, 12 females) treated by maintenance hemodialysis were autopsied in our department. Primary diseases of the autopsied cases were chronic glomerulonephritis (12 cases), diabetes mellitus (three cases), hydronephrosis (three cases), systematic lupus erythematosus (two cases), myeloma kidney (one case) and atherosclerosing nephropathy (one case). Direct causes of death in maintenance hemodialysis patients were bleeding (six cases), uremia (three cases), infection (three cases), carcinoma (four cases), heart failure (two cases), myocardial infarction (one case), brain ischemia (one case), cardiac tamponade (one case) and unknown (one case).
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PMID:Autopsy findings in maintenance hemodialysis patients. 653 69

Contrast nephropathy is an adverse alteration in renal function induced by intravascular contrast media. Most cases involve transient asymptomatic episodes; yet a significant number involve oliguria and/or permanent renal damage. The incidence of contrast nephropathy in the general hospitalized population is about 5%, and is associated with preexisting renal insufficiency and diabetes mellitus. The incidence in patients with normal renal function is significantly lower - 0.6% following IVP and 2% following angiography. Angiography carries risks inherent to the technical problems of the procedure itself. Preexisting renal insufficiency is the most significant predisposing condition of contrast nephrotoxicity. As many as two-thirds of patients with chronic renal failure may experience an acute deterioration in renal function following exposure. Most of these episodes are transient and benign. Diabetic patients with preexisting renal insufficiency are at an even greater risk; about 75% of such patients will experience renal complications. The risk is even higher in JODM patients with severe renal disease; there is an over 90% incidence of nephrotoxicity with as many as half sustaining permanent renal damage. Adequate hydration does not appear to reduce the incidence of contrast nephropathy in susceptible patients, but it may reduce the likelihood of oliguria and permanent damage. In multiple myeloma the risk of contrast-induced renal failure is low, and probably involves a different pathogenesis than seen in other cases of contrast nephropathy. The incidence in myeloma patients is probably increased in the presence of dehydration and renal insufficiency. Peripheral vascular disease, hypertension, old age and large and repeated doses of contrast may increase the risk in susceptible patients. Prevention of contrast nephropathy must start with identification of patients at risk. In patients with preexisting renal insufficiency, and especially diabetic patients with preexisting renal insufficiency, the anticipated benefit should outweigh the potential risk of exposure to contrast media.
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PMID:Contrast nephropathy. 675 74

Twenty cases of sonographically visualized thickening of the gallbladder wall were reviewed and the clinical diagnoses compiled. In only eight of these patients was cholecystitis considered responsible for the finding. The rest had hepatitis, alcoholic liver disease with hypoproteinemia, heart failure, renal disease, and multiple myeloma; however, all lacked clinical evidence of gallbladder disease. Because of these findings, caution is urged in making the diagnosis of cholecystitis on the basis of wall thickening alone.
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PMID:Sonography of the thickened gallbladder wall: a nonspecific finding. 678 Dec 56

A prospective study was undertaken of 15 patients with impaired renal function undergoing x-ray procedures entailing the use of contrast material to see whether any deterioration in renal function resulted. Patients with diabetes or myelomatosis were excluded. Detailed observations were made during three days before and after the x-ray procedure to detect any change in factors such as fluid state, drug treatment, infection, or diet which might have affected renal function. No significant changes occurred in endogenous creatinine and 51Cr-EDTA clearances, or in plasma creatinine and urea concentrations after the x-ray procedures. Furthermore, there was no change in urinary activity of N-acetyl-beta-D-glucosaminidase, which is a highly sensitive indicator of renal parenchymal damage. Provided that fluid depletion and multiple x-ray procedures with radiocontrast material in rapid sequence are avoided, these procedures do not appear to affect renal function adversely, even when renal disease is advanced.
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PMID:Effect of radiocontrast media on kidneys of patients with renal disease. 678 30

In 13 specimens of renal tissue from 11 patients, deposits of monoclonal immunoglobulin light chains and continuous granular electron-dense material within tubular basement membranes and in association with the glomerular basement membrane were identified. All but one patient were men n the fifth to seventh decades of life, and each presented with azotemia and features of glomerular rather than tubulointerstitial disease. Osteolytic bone lesions occurred in only three patients, and a bone marrow plasmacytosis greater than 30 percent consistent with plasma cell myeloma was identified in only four patients. Light chain distribution in the nephron was confirmed with immunoelectron microscopy and was not associated with deposition of other serum proteins such as immunoglobulin heavy chains, complement, transferrin, alpha 2 macroglobulin and albumin. The electron dense deposits differed in distribution and character from those associated with membranoproliferative glomerulonephritis type II (dense deposit disease), amyloidosis, cryoglobulinemia, macroglobulinemia and benign monoclonal gammopathy. Serum from six of these patients did not bind to normal human or rat renal parenchyma in vitro. Kappa light chain nephropathy was characterized by predominant linear tubular basement membrane kappa deposits, and nodular mesangial and linear glomerular basement membrane kappa immunostaining. Lambda light chain nephropathy was characterized by linear lambda glomerular basement membrane and tubular basement membrane immunostaining. Manifestations of glomerular dysfunction dominated the clinical presentation of light chain nephropathy, and most patients did not have typical features of multiple myeloma. The diagnosis was predicated upon thorough immmunohistologic assessment of renal biopsy material.
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PMID:Light chain nephropathy. 678 78

A 52 year old man was admitted to hospital for persistent back pain, fixed proteinuria of 6g/24 h that lead to the nephrotic syndrome (proteids 40 g/l, albumin 21,2 g/l). Two possible etiologies were envisaged: 1) Myeloma with K light chains as evidenced by biological findings (absence of normal Ig, presence of K light chains both in blood and urine, malignant medullary plasmocytosis) as well as x-rays (small punched out lesions). 2. Diabetes mellitus (blood glucose 2,4 g/l) with retinal and neurological involvement. Percutaneous renal biopsy revealed nodular glomerular sclerosis compatible with both diabetes and myeloma as well as homogeneous refringent thickening of tubular basement membranes more specific of myloma. No amyloid deposits, myelomatous casts were seen and anti-K light chain fixation was negative at immunofluorescence. An evolution of 33 months duration let to chronic renal failure (plasma creatinine 47 mg/l). The respective role of myeloma and diabetes in the genesis of this glomerular nephropathy are discussed.
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PMID:[Glomerulosclerosis: myeloma or diabetes? (author's transl)]. 679 47

Paraproteinemias can be subdivided in 1. obligatory paraproteinemias (myeloma, macroglobulinemia, heavy chain diseases); 2. accompanying paraproteinemias (Non-Hodgkin's lymphomas, myeloproliferative diseases, immune deficiency diseases, autoimmune diseases, transitory paraproteinemias after infection, paraproteinemias in association with nonlymphatic neoplasms); 3. benign paraproteinemias: a) with symptoms (primary amyloidosis, chronic cold agglutinin disease, paraproteinemias with further autoantibody function, monoclonal cryoglobulinemia); b) asymptomatic forms. Myeloma is the most common type of obligatory paraproteinemias. Characteristic findings are: Paraproteinemia and/or paraproteinuria in 98%, increase of plasma cells in the bone marrow in 84%, alterations in the roentgenograms of the skeleton in 79%. Clinical staging is of importance for the prognosis (amount of paraproteins, Hb level, renal disease, hypercalcemia, lytic lesions of bone). Neurologic complications, hemostasis dysfunction, cryopathies may be other symptoms. The terminal phase of the disease is determined by plasma cell proliferation, immune deficiency and renal disease or myelomonocytic leukemia. As to Non-Hodgkin's lymphomas the accompanying paraproteinemia is to be found in immunocytomas and in CLL. At last it has to be mentioned that B-cell disorders will influence the T-cell populations and vice versa.
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PMID:[Clinical aspects of monoclonal gammopathies in diseases of the lympho-plasmacytic cell system]. 681 57

Renal biopsy and autopsy specimens were studied in 43 patients with renal complications of multiple myeloma and correlated with immunoelectrophoresis (IEP) and other clinical data at the time of biopsy. Lesions specifically related to multiple myeloma fell into two categories, with different patterns of protein excretion. (1) Myeloma Cast Formation: When other lesions which might contribute to renal insufficiency (RI) were excluded, there was a good correlation between the extent of myeloma cast formation and severity of RI. Sixteen of 19 patients excreted free light chains (LCs) in the urine, in seven as the predominant or sole urinary protein. (2) Tissue Deposition of Paraproteins: Nine cases had generalized glomerular, tubular basement membrane and vascular deposits of presumed kappa-chains (one with associated alpha-heavy chains). Four patients, all with myelomas secreting lambda LCs, had diffuse amyloid deposits in similar distribution. All patients (save two who were anuric) had diffuse, nonselective proteinuria by IEP, most within the nephrotic range. Four patients had free LCs in the urine, but in none was this the predominant component. Cast nephropathy and LC tissue deposition tended to occur in mutually exclusive fashion. Cases with diffuse tissue deposits of LCs showed few or no myeloma casts. Cases with cast nephropathy had only occasional mild mesangial lesions and focal interstitial and vascular deposits of amyloid. Evidence indicates that these lesions represent incidental LC deposition in cases whose basic lesion is longstanding and/or severe cast nephropathy, and that their contribution to RI is minor in comparison to that of the myeloma casts.
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PMID:Renal lesions in multiple myeloma: their relationship to associated protein abnormalities. 682 60

The types of renal disease that are particularly common in the elderly include acute renal failure, prerenal azotemia, multiple myeloma kidney, and obstruction. Hemodialysis and peritoneal dialysis, now proven effective in controlling renal disease in older patients, require special considerations when applied to the elderly patient.
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PMID:Renal disease in the elderly. 707 79

The simple postabsorptive urine hydroxyproline (Spot-HYPRO) with dialyzable and non-dialyzable (ND) fractions was measured in 28 patients with multiple myeloma. Myeloma patients with bone disease had higher total Spot-HYPRO and dialyzable fractions (P less than 0.001) than myeloma patients without bone disease or controls. The ND fraction of the Spot-HYPRO was elevated in myeloma patients with renal disease as compared with myeloma patients without renal disease and controls (P less than 0.01). Follow-up studies of ten myeloma patients demonstrated a close correlation between Spot-HYPRO and the dialyzable fraction and the evolution of bone disease. The Spot-HYPRO and its dialyzable fraction constitute a simple, inexpensive, and accurate test for the diagnosis and follow-up of the skeletal disease in patients with multiple myeloma.
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PMID:The postabsorptive urinary hydroxyproline (spot-HYPRO) in patients with multiple myeloma. 724 5


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