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

The coexistence of a myeloma and Paget's disease in the same patient is only rarely reported in the published literature. The frequency of such an association was studied when reviewing 3 cases observed by the authors: an IgG myeloma discovered following a spasmodic paraplegia in a patient with Paget's disease; a patient who was found to have a myeloma, a polynuclear neutrophil leukemia, and Paget's disease; and an IgG myeloma in a patient with probable localized Paget's disease. The incidence of the association myeloma-Paget's disease is much lower than that of sarcomatous degeneration. It should be determined precisely, however, as our future conception of the reciprocal relationship between the two diseases is greatly dependent on this information. Furthermore, the very few cases reported, and their lack of homogenicity, are the reasons why most authors feel that the association of myeloma and Paget's disease as pure coincidence. Many new cases, however, have been recently reported. The problem of the significance of the association of Paget's disease and macroglobulinemia or other monoclonal gammapathies has still to be solved.
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PMID:[The association of a myeloma and Paget's disease (author's transl)]. 43 30

A diagnosis of vertebral multiple myeloma, based on radiographic evidence of osteolytic lesions and the finding of monoclonal paraprotein and large numbers of plasma cells in bone marrow biopsies, was made in a mature Doberman Pinscher. The abnormal serum paraprotein was a cryoglobulin of the immunoglobulin A class. Neurologic signs associated with the tumor included pain, progressive pelvic limb paresis, and paraplegia that developed during a 6-week period.
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PMID:Neurologic complications of IgA multiple myeloma associated with cryoglobulinemia in a dog. 51 33

We describe the case of a 75 year old male patient, hospitalized because of sudden paraplegia. The radiological tests performed, revealed degenerative changes of the entire vertebral spine, osteolytic lesions of the seventh cervical and first two thoracic vertebrae, and lacunar lesions of the others. The erythrocyte sedimentation rate, total proteins and its electrophoretic study, as well as quantification of serum immunoglobulins were found to be normal. Regardless of these results, we continued our investigation in order to diagnose or exclude multiple myeloma (MM), which was confirmed by serum and urinary immunoelectrophoresis, that revealed monoclonal gammopathy IgG, K with low value of serum IgG and very high urinary values of Bence Jones K, and by the histological analysis of the necropsy material. In conclusion, we report a case where the probability of an alteration of the controlling immunological mechanisms must be considered. We suggest that there is a heavy chain suppression of the malignant clone, that would explain its very low value in peripheral blood. These findings associated to the absence of light chains in serum, have lead to a particular laboratorial expression of this myeloma.
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PMID:[Multiple myeloma. An unusual case]. 160 72

The authors have retrospectively studied 22 cases of spinal cord compression among 184 patients having multiple myeloma or plasmocytoma. Neurological signs were the initial symptoms of the malignant plasmocytosis in 32% of the cases. Seven patients had paraplegia, 13 paraparesia and three had no motor involvement. A laminectomy was performed in half of the cases (with or without local radiotherapy and/or chemotherapy); the 11 other patients were treated by radiotherapy and/or chemotherapy alone. Sixteen patients (72%) improved, 10 in the laminectomy group and six in the other. The improvement seemed to be better after the laminectomy (and/or radiotherapy or chemotherapy) but to a lesser extend if the patients were paraplegic, in case of sudden onset and of compression at the thoracic level. The median of survival was 30 months. They emphasize the utility of magnetic resonance imaging for the diagnosis of epidural involvement before the occurrence of objective neurological complications.
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PMID:[Myeloma and epidural invasiveness. Clinical and therapeutic aspects (a study of 22 cases)]. 192 95

A 48-year-old man developed a marked and persistent hypercalcemia 3 months after admission for paraplegia resulting from severe peripheral neuropathy most likely of alcoholic etiology. Serum ionized calcium was elevated, and parathyroid hormone levels were low normal by the two separate radioimmunoassays. Urinary calcium excretion was markedly elevated, and serum 1,25-dihydroxyvitamin D level was decreased. An extensive clinical evaluation for possible occult malignancy, myeloma, and sarcoidosis as a cause of hypercalcemia produced no positive findings. Treatment with calcitonin caused prompt normalization of serum calcium, and its discontinuation resulted in recurrence of hypercalcemia. With improvement of neuropathy, the patient started active physical therapy. We gradually discontinued calcitonin, and the patient's serum calcium remained normal during the following 11 months. We discuss difficulties in both clinical and laboratory diagnosis of hypercalcemia of immobilization in the adult patient because no specific laboratory test is available.
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PMID:Hypercalcemia of immobilization in an adult patient with peripheral neuropathy. 253 19

In three patients with multiple myeloma, stage IIIA, a complete remission lasting from 6 to 8 years was attained, in spite of the fact that not all of them received treatment. In the latter case the remission lasted from 5 to 6 years. One of the patients had diffuse Gk + BIk myeloma, one presented with multiple focal one with protein BIk production, and one patient had multiple focal myeloma with spinal cord compression and complete lower paraplegia without verified secretion of monoclonal immunoglobulin. The times of therapy until the attainment of a complete remission were 3,5 and 13 years, whereas the total survival amounted to 9, 5 and 20 years since the appearance of the first disease symptoms. Sarcolysine was employed as the basic cytostatic agent in all the cases. Annual control examinations of the patients in a state of remission have not revealed any signs of myeloma. One patient is manifesting osteolytic deficiencies, however biopsy withdrawn from the focus of osteolysis have not shown any tumor. Immunochemical assay of serum and urine has failed to detect paraprotein, blood immunoglobulins have been discovered to be within normal. The author analyses 4 similar cases reported in literature. It is assumed that it would be premature to regard the patients described above as completely recovered from the biological standpoint and that it would be more wise to consider such cases as prolonged and fairly profound remissions.
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PMID:[Possibility of complete recovery in multiple myeloma]. 404 70

Myeloma may be complicated or revealed by spinal cord compression. Out of 105 cases of myeloma admitted to this Department, 6 cases of spinal cord compression were observed, with a favourable outcome after treatment by laminectomy combined with radiotherapy. In 5 cases out of 6, spinal cord compression was either the presenting sign or occurred within the first months after diagnosis. Compression occurred in the thoracic cord in 5 cases, and in the lumbar cord in 1 case. The interval between the first symptom and diagnosis varied greatly (from a few hours to 1 year), as did the degree of paraplegia, which ranged from paraparesis to flaccid paraplegia. A favourable outcome occurs in most other reported cases, in contrast with spinal cord compression from metastases. Treatment (laminectomy-radiotherapy or both) remains controversial.
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PMID:[Spinal cord compression in malignant plasmacytic diseases. Apropos of 6 cases]. 671 66

The clinical and immunochemical presentations of immunocytomata in black and white South African patients are described. Age distribution in white patients is similar to previously published series. However, black patients with multiple myelomatosis and Waldenstrom's macroglobulinaemia on average presented clinically ten and twenty years respectively earlier than white patients. No significnat differences in the various immunochemical classes of multiple myelomatosis was shown despite greater serum immunoglobulin concentrations (especially IgA) in the black population. Age adjusted incidence rates for multiple myelomatosis in South African blacks were as high as those in the United States and Jamaica. This finding contrasts with low rates previously reported in Africa. Furthermore, age adjusted incidence rates for multiple myelomatosis in South African whites were higher than those in whites reported in the United States. There was a higher incidence in blacks of fractures of the thoracolumbar spine with collapse and consequent paraplegia and urinary tract infection. While there was a greater frequency of solitary myeloma in black patients, cases of benign paraproteinaemia were seen only in white patients.
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PMID:Immunocytoma in black and white South Africans. 677

The clinical features and the treatment results of 15 patients with solitary plasmacytoma of the spine observed in a 28-year period (1950-1977) are reported. The signs at presentation were back pain in 4 cases and spinal cord compression in 11 cases. Three of these patients had paraplegia. Radiologically, the alteration encountered was an osteolytic lesion in all cases. The local treatment was radiotherapy in 11 cases and surgery plus radiotherapy in 4 cases. In 3 patients systemic chemotherapy was also employed. Seven patients are alive without signs of disease 3 to 9 years (mean 6 years) after diagnosis. Eight patients developed multiple myeloma in a period ranging from 1 to 8 years (mean 3.5 years). The relationship between multiple myeloma and solitary plasmacytoma of the spine, as well as the best treatment for the latter, are discussed.
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PMID:Solitary plasmacytoma of the vertebral column. A report of 15 cases. 713 92

A case is reported of multiple myeloma presenting with signs and symptoms of paraplegia in a patient with a history of hypertension and remote cerebral vascular accident. The laboratory findings of hyperproteinemia and uricemia suggest a protein synthesizing abnormality. This case emphasizes that most patients with protein abnormality should be investigated by protein electrophoresis and immunoelectrophoresis.Unusual clinical presentation of multiple myeloma may result in an erroneous diagnosis unless proper investigation in the appropriate line is made.
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PMID:Multiple myeloma: presenting as a neurological disorder. 736 13


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