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)

Out of a group of 57 patients with the diagnosis of multiple myeloma fourteen (25%) with different degrees of renal disease were selected. Bence-Jones (BJ) proteinuria, infections, and, above all, the tumoral cell mass were the three main factors implicated in the development of myeloma associated renal disease. Only 13% of IgG myelomas presented with renal failure as compared to 27% of IgA myelomas. The patients with BJ and IgD myeloma, classically those with a higher tendency to develop renal disease (in our series 37% of BJ myelomas and 50% of IgD myelomas had renal disease), had the biggest tumoral cell mass of all patients studied. The relationship between tumor cell mass and renal disease in myeloma is supported by the recovery of renal function in a patient with chronic renal failure after a treatment-induced reduction of the tumoral cell mass from 1.71 to 0.82 x 10(12) cells/m2 body surface.
 ...
PMID:[Renal disease in myeloma. Role of the tumor cell mass (author's transl)]. 725 52

The present study describes our experience with CAPD in an unselected group of patients presenting with endstage renal failure. Twenty-three consecutive patients were offered CAPD, in-center, and home hemodialysis. Twenty-two patients selected CAPD, including 14 patients more than 60 years of age, four patients with diabetes, and one with multiple myeloma. CAPD training was performed in an out-of-hospital office facility. One patient returned to hemodialysis following the development of resistant Pseudomonas peritonitis, two patients died of a myocardial infarction, and one patient died with a GI bleed. The other 18 patients are doing well. Assessment of 17 patients maintained on therapy for four months or more revealed that the patients are less depressed, less organic, and have fewer physical symptoms than previously reported for a comparable group of patients maintained on hemodialysis for a similar period of time. In conclusion, CAPD can be successfully employed, at least for the initial months of therapy, to treat the vast majority of patients with endstage renal disease. CAPD training and follow-up care can be provided in an out-of-hospital office facility.
 ...
PMID:Continuous ambulatory peritoneal dialysis: experience with 22 unselected patients with renal failure. 726 43

Twenty patients with multiple myeloma and renal failure were treated by dialysis and chemotherapy consisting of prednisone and melphalan. Of nine patients treated by short-term dialysis, only two recovered renal function despite correction of fluid and electrolyte disorders, hypercalcemia, and hyperuricemia. The remaining seven patients died within 2 months in a uremic state, and one of the patients who recovered renal function died 14 months later of bronchopneumonia. In contrast, long-term hemodialysis and chemotherapy in 11 patients resulted in sufficient improvement in 8 patients to permit a degree of rehabilitation comparable to that achieved in patients with primary renal disease who have progression of the multiple myeloma. Of the 20 patients, 6 survive 7 to 48 months after beginning treatment.
 ...
PMID:Dialysis in the treatment of multiple myeloma. 735 48

Nodular regenerative hyperplasia was found in nine patients who had hematological disease including polycythemia vera, agnogenic myeloid metaplasia, primary thrombocythemia, rheumatoid arthritis with thrombocytosis, multiple myeloma, and erythrocytosis associated with polycystic renal disease. Portal hypertension was suspected in three and features of hypersplenism were present in four. 2. Nodular regenerative hyperplasia occurred in livers which had widespread obliteration of portal vein radicals (obliterative portal venopathy). Morphometric analysis indicated that the portal vein lesions were predominately located in veins up to 0.2 mm in diameter and were significantly more frequent than similar lesions occurring in elderly persons. 3. The following pathogenesis of nodular regenerative hyperplasia is proposed: Thrombi, perhaps largely composed of platelet aggregates formed in the portal venous circulation or spleen, embolize to the liver and results in obliterative vascular lesions. Atrophy and regenerative nodule formation occur in response to the interruption of the portal blood supply.
 ...
PMID:Nodular regenerative hyperplasia of the liver in hematologic disorders: a possible response to obliterative portal venopathy. A morphometric study of nine cases with an hypothesis on the pathogenesis. 743 53

This paper describes tubulointerstitial changes of the kidney in association with a) pathophysiology of paraproteinuria and related disorders, and b) the management of leukemia and malignant lymphoma. Various forms of tubulointerstitial changes might be provoked following the accumulation of "abnormal macromolecules" In a), multiple myeloma, light chain cast nephropathy (myeloma kidney), AL amyloidosis, light chain deposition disease, macroglobulinemia, cryoglobulinemia etc. are briefly reviewed. In the majority of cases, leukemia and lymphoma do not manifest themselves as tubulointerstitial disorders. However, a large number of patients suffer from tubulointerstitial abnormalities in the course of and/or after receiving chemotherapy. Thus it is explained, in b), why treatment for hematological malignancy is apt to induce tubulointerstitial complications. In this context, drugs responsible for the development of tubulitis and/or interstitial fibrosis are briefly reviewed.
 ...
PMID:[Tubulointerstitial changes in some hematological disorders]. 756 42

Kidney tubule dysfunction and lesions are frequent complications of myeloma, related to unknown properties of the monoclonal light chain. We have analyzed protease sensitivity and binding properties of urinary light chains from four patients with Fanconi's syndrome, 12 with cast nephropathy, and four control patients without myeloma-associated tubulopathy. All light chains were normal-sized, monomeric and/or dimeric, and none was N-glycosylated. Kinetic studies of light chain digestion by pepsin and the lysosomal enzyme cathepsin B showed the generation of a protease-resistant 12 kDa fragment, corresponding to the V domain of the kappa chain in the four Fanconi's syndrome patients; in two out of four the V domain was also completely resistant to trypsin. Western and dot blots revealed similar patterns of reactivity of light chains from patients with the Fanconi's syndrome towards other light chains. Properties of cast-nephropathy light chains were more heterogeneous but clearly differed from those of Fanconi's syndrome: (i) 9 out of 12 were of the lambda-type; (ii) only four yielded a transient 12 kDa fragment after cathepsin B digestion, but all showed some resistance to proteolysis of the entire molecule or a fragment thereof to at least one protease, at variance with control light chains; (iii) they displayed various patterns of reactivity with other light chains; (iv) 7 out of 12 reacted specifically with Tamm-Horsfall protein (THP) by ELISA, in contrast with those of Fanconi's syndrome. In one patient who presented with cast nephropathy and the Fanconi's syndrome, the light chain exhibited both partial resistance of the V kappa domain to cathepsin B and the highest reactivity with THP.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Protease resistance and binding of Ig light chains in myeloma-associated tubulopathies. 756 94

The study of monoclonal immunoglobulin-associated nephropathies is useful for analyzing the physicochemical properties of immunoglobulin components responsible for their deposition in the kidney. Notable advances include the first description of truncated heavy-chain deposition disease, characterization of protease resistance and binding properties of immunoglobulin light chains involved in myeloma-associated Fanconi's syndrome and cast nephropathy, and identification of hepatitis C virus as a plausible causative agent of the so-called essential mixed cryoglobulinemias.
 ...
PMID:Renal involvement in hematological disorders: monoclonal immunoglobulins and nephropathy. 760 43

We evaluated retrospectively the presenting clinical features, response to treatment and clinical course of 19 patients with LCDD, 11 of whom had multiple myeloma. At presentation, renal insufficiency was present in 18 patients and proteinuria in 16. Renal biopsy revealed typical LCDD in 16 patients, while in the remaining three LCDD was associated with other abnormal tissue deposits. Extrarenal signs were observed in 12 patients (63%), with the liver, heart and peripheral nerves being the most frequently involved organs. After diagnosis, 18 patients underwent therapy: 2 received steroids alone and 16 were treated with steroids and cytotoxic drugs; 7 patients also underwent plasma exchange. At the end of the first month of treatment renal function improved in 5 patients, worsened in 5 and remained unchanged in 8. All but 3 of the patients continued treatment beyond the first month: 7 patients developed end-stage renal disease, 5 an improvement and 4 a worsening in renal function. No effect on proteinuria was observed. Extrarenal symptoms developed in 4 previously unaffected patients and in 3 others they extended to more organs. Sixteen patients died: 12 during the first year of the follow-up, and 4 at 21st, 34th, 37th and 82nd month of observation. Five patients died from neoplastic cachexia, 4 from hypokinetic cardiopathy, 3 from hemorrhagic complications, 2 from pneumonia and one from unknown cause. Mean patient survival after presentation was 18.1 +/- 20.7 months.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Renal disease and patient survival in light chain deposition disease. 763 43

Renal failure is a common complication of multiple myeloma, because the kidney is a major target organ for the deposition of paraproteins such as Bence Jones protein (BJP), light chain fragment of monoclonal immunoglobulins, secreted by plasmacytoma. There are three forms of renal involvements related to multiple myeloma. The most common form is cast nephropathy ("myeloma kidney") due to precipitation of BJP combined with Tamm-Horsfall protein in the distal nephron. Other two forms are amyloid nephropathy and light chain deposition disease (LCDD). Renal failure is usually arising from myeloma kidney and is exacerbated by many other factors, for example, concurrently imposed chemical agents. In this manuscript, the mechanism of renal failure mainly due to myeloma kidney and its managements are mainly described.
 ...
PMID:[Renal failure]. 769 9

The renal involvement in a multiple myeloma case (MM) has a frequency of 50% and causes a worsening of the disease with a survival average of about 12 months. Myeloma cast nephropathy (MCN) represents the more frequent clinic, histological form of nephropathy in course of MM and it evolves when monoclonal light free chain deposit in the renal tubules together with some other worse cases like dehydration and/or hypercalcaemia. We analyze here the clinical and renal histological features of eight patients treated for acute renal failure found in MCN in course of MM grade B. This was discovered through renal bioptic check-up. We have evaluated the Bence-Jones proteinuria, the recurrence of the condition of risk and the course of the renal failure of these patients also in order to treat the hematological illness.
 ...
PMID:[Acute kidney failure in the patient with multiple myeloma. An analysis of the authors' personal cases]. 775 76


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>