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Query: UMLS:C0026764 (multiple myeloma)
 36,148 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Diagnosis of myeloma depends on identification of malignant plasma cells and the product of these cells, a monoclonal immunoprotein. Of the clinical manifestations of plasma cell myeloma, skeletal pain and anemia are two of the more common. Unexplained anemia and osteoporosis noted in the elderly should suggest the possibility of myeloma; this combination of symptoms certainly warrants obtaining a protein electrophoresis. Hypercalcemia and renal insufficiency are frequent sequelae of myeloma.
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PMID:Diagnosis of plasma cell myeloma. 4 74

The treatment of rapidly progressive skeletal demineralisation in myelomatosis has been studied with the help of metabolic calcium balance in two patients; In one, osteoporosis accelerated during treatment with melphalan and prednisolone, although he remained normocalcaemic throughout, suggesting that osteoporosis was aggravated by corticosteroid therapy. In the other patient, who was initially hypercalcaemic, conventional treatment produced clinical remission before eventual relapse with more hypercalcaemia and skeletal dissolution. Both patients were then treated with mithramycin alone, and, although neither obtained haematological remission, bone pain was relieved, hypercalciuria and hypercalcaemia were abolished, and calcium balances proved that mithramycin was effective in restoring calcium equilibrium. The results indicate that mithramycin may abolish excessive bone resorption in myelomatosis and that severe bone dissolution may occur in the absence of hypercalcaemia. Regular determination of 24-hour urinary calcium excretion as well as of plasma-calcium is important in monitoring process. Mithramycin should be considered in the early treatment not only of hypercalcaemia but also of severe hypercalciuria, if these complications do not rapidly remit during the first course of conventional myeloma therapy, with or without steroids. Finally, these results add to evidence that a humoral factor may be responsible for osteoclast stimulation in myelomatosis.
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PMID:Treatment of osteolytic myelomatosis with mithramycin. 4 84

Multiple myeloma is very frequently diagnosed too late. In ten patients in whom the diagnosis was ultimately made in the course of one year, the early symptom of back or skeletal pain was at first most frequently misdiagnosed as osteoporosis and so treated. Such symptoms as loss of weight, increased sedimentation rate and increase in gamma-globulins should have led to further tests, for example sternal puncture, radiological survey of the entire skeleton, and immuno-electrophoresis.
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PMID:[False diagnosis of "osteoporosis" in diffuse multiple myeloma (author's transl)]. 6 62

Back pain is one of the chief complaints of the elderly. It may be either a chronic deep skeletal muscular pain or an acute circumscribed pain arising from nerve-root irritation. The main causes of back pain in older people are: 1) degenerative changes (spondylosis, osteoarthritis, ankylosing hyperostosis); 2) malignancy (multiple myeloma, metastases from carcinoma or lymphoma); and 3) metabolic disorders (osteoporosis, osteomalacia, chondrocalcinosis, Paget's disease). Mechanisms and variations are discussed in detail.
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PMID:Back pain: osteoarthritis. 13 24

The diagnosis of osteoporosis is usually based on the presence of hypertransparent radiological images of the spinal column with vertebral collapse, when other relatively rare causes (mainly myeloma) have been excluded. One recognized, other etiological factors have to be discarded, especially cortisone therapy, before diagnosing primary osteoporosis in patients over 55 years of age in whom it is more frequently present in women (post-menopausal osteoporosis). Various indices of the amount of bone present in the limbs and pelvis can be used to assess the proportion lost with age, but these give only incomplete information on the degree of vertebral osteoporosis.
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PMID:[Diagnosis of primary osteoporosis (author's transl)]. 43 24

The dosage of calcium ionized serum using a selective electrode, was performed in a series of controls and patients with osteo-articular diseases. Normal values were 43 mg/l between 20 and 50 years of age, and 41 mg/l after 60 years. The level of ionized calcium, when given as a percentage of total blood calcium, did not decrease with age (normal value : 44%). It was increased in hyper-parathyroidism, rhumatoid polyarthritis and lytic bone metastasis. It did not vary in Paget's disease, osteoporosis, osteomalacia, condensing metastasis, Kahler's disease and spasmophilia. The ionized calcium in definitely diminished in hypoparathyroidism.
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PMID:[Dosage of ionized calcium in osteo-articular pathology]. 68 54

Obviously, the relentless decrease in bone mass that accompanies aging will continue the long sought "elixir of youth" is discovered. Individuals, because of race, sex, environmental, dietary, genetic or activity differences, will be more or less predisposed to symptomatic osteoporosis with increasing age. The careful and knowledgeable physician should, however, make every attempt to rule out potentially remediable, subtle forms of demineralizing disorders, such as apathetic or T3-thyrotoxicosis, hyperparathyroidism, malabsorption and osteomalacia or multiple myeloma. Not only do these diseases result in an accelerated loss of bone mass and an increased incidence of skeletal fractures but they mimic postmenopausal or senile osteoporosis radiologically. Once the metabolic or malignant disorders of bone metabolism have been effectively considered and ruled out, the senescent or postmenopausal osteoporotic patient should be treated judiciously with short-term estrogen therapy, a diet sufficient in vitamin D and calcium content and continued attempts to insure adequate skeletal mobilization. The addition of sodium fluoride and/or calcitonin to this regimen should not be attempted without extreme caution until the potentially harmful systemic effects of prolonged therapeutic trials have been appropriately assessed.
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PMID:Senile and postmenopausal osteoporosis. 76 91

A patient with multiple myeloma died of an acute myeloid leukaemia 15 years after onset of the former. At time of diagnosis the 39 year-old-patient had bone marrow infiltration of maximally 32 plasma cells/100 white bone marrow cells, a paraprotein (IgG, light-chain type lambda), osteoporosis of late onset and occasional osteolysis. The long survival time, as well as the acute myeloid leukaemia, are probably due to the effective treatment, first with cyclophosphamide (198 g over four years), later melphalan (3000 mg over eight years).
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PMID:[Multiple myeloma and terminal acute myeloid leukaemia (author's transl)]. 81 90

The reports on the occurrence of myeloma in two or more members of the same family are very scanty, and until present, only about twenty observations of the familial occurrence have been reported. In this paper the observation of multiple myeloma in two brothers is described. The clinical diagnosis was confirmed by the bone marrow biopsy which showed an infiltration of abnormal plasma cells. X-ray examination of the skeleton revealed typical osteolytic changes in one patient and diffuse osteoporosis in the other. Moreoever both patients had a massive monoclonal protein fraction in serum and Bence-Jones protein in urine. In one case the monoclonal serum protein was of the IgG-K type and in the other, of the IgA-K type. Thus the antigenic determinants were different in the class specificity. Immunoglobulin studies among healthy relatives of the two brothers demonstrated much higher incidence of the polyclonal increase in one immunoglobulin class than could be expected in the population. Without evidence of monoclonal serum protein, unusally high IgA serum levels, more than 500 mg/100 ml, were observed in seven of seventeen healthy family members. This could be explained on genetic basis in connection with the familial occurrence of myeloma either by an abnormal distribution of plasma cell clones or by their abnormal activity. However, a defective control mechanism in protein synthesis may also be taken into consideration.
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PMID:Multiple myeloma in two brothers. Immunoglobulin levels among their relatives. 93 88

The designation "pseudomyeloma'' is used to describe three patients who had a clinical picture that closely resembled multiple myeloma and was characterized by severe osteoporosis and a serum monoclonal paraprotein peak. The diagnosis of myeloma could not be made histologically, initally or after three, four, or ten years of observation. The protein abnormalities and the bone marrow picture remained stable. It is not known if this association has pathophysiologic importance or if it represents a chance phenomenon.
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PMID:Pseudomyeloma. Is association of severe osteoporosis with serum monoclonal gammopathy an entity or a coincidence? 114 30


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