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)

Monoclonal gammopathy of type IgG-lambda (IgG concentration 27.8 g/l) was discovered by chance in a 66-year-old woman with aortic and mitral valve disease. The patient declined any further diagnostic procedures. Three months later she experienced severe pain in the lumbar spine and developed decompensated cardiac failure with pulmonary and ankle edema. The IgG concentration had risen to 50.5 g/l. Echocardiography showed a large pericardial effusion and 600 ml of bloodstained fluid containing numerous plasma cells was aspirated (total protein 81.8 g/l, gamma-globulin 38.9%). Iliac crest biopsy showed diffuse infiltration with polymorphic plasma cells, but the differential count in peripheral blood was unremarkable. Multiple myeloma of Stage IIa was diagnosed and she was given cytostatic therapy with 17.5 mg melphalan and 112 mg methylprednisolone daily by mouth (for 4 days at intervals of 6 weeks). Though at first the IgG concentration fell, it later rose again. The beta 2-microglobulin level was raised at 30 mg/l. After three cycles of chemotherapy the patient complained of severe pain in the hips and thighs. The blood film now showed numerous, predominantly immature plasma cells. A few days later, having been ill for four months in all, she died, showing all the signs and symptoms of plasma cell leukaemia.
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PMID:[IgG-lambda-type multiple myeloma with plasma-cell pericardial effusion and terminal plasma-cell leukemia]. 142 69

Three patients with cardiac tamponade caused by malignancy were treated by pericardiocentesis with intrapericardial OK-432 instillation. The underlying disease was adenocarcinoma of unknown origin, breast cancer and multiple myeloma. Under electrocardiographic monitoring, a polyethylene catheter with several side holes was inserted into the pericardial sac, and after a maximal volume of fluid was withdrawn, 5 KE of OK-432 diluted in 20 ml of saline was instilled through the catheter. All the patients who received intrapericardial OK-432 therapy obtained complete control of pericardial effusion for more than 30 days. The side effects were fever, chills and chest pain which were easily controlled by antipyretics.
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PMID:Intrapericardial instillation of OK-432 for the management of malignant pericardial effusion: report of three cases. 272 48

Of 14 patients who received an allogeneic bone marrow graft from HLA-compatible sibling donors, 10 have survived for 6 to 34 months posttransplantation (median, 12 months). Four patients have died, two of relapse at extramedullary sites, one of severe acute GVHD, and one from GI bleeding and pericardial effusion. One patient is alive in relapse and four patients have signs of minimal persistent disease. Five patients are well without signs of active disease. Minor improvement in osteolytic lesions on X-ray were seen in three patients, but the X-ray bone structure was mainly unchanged in most patients. Bone marrow transplantation appears promising for treatment of certain patients with multiple myeloma.
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PMID:Bone marrow transplantation in multiple myeloma: report from the European Cooperative Group for Bone Marrow Transplantation. 354 46

A 67-year-old male was admitted to our hospital because of anemia, thrombocytopenia, and renal failure. On admission he showed splenomegaly and elevated serum LDH level. Bone marrow showed hypercellularity with massive infiltration of lymphoblastoid cells. He was diagnosed as having multiple myeloma (BJ-kappa, stage IIIB). He transiently responded to intensive chemotherapy (VAD, MP, IFN alpha) but relapsed with multiple subcutaneous tumors and pericardial effusion. This is a rare case that the myeloma cell invasion to pericardial space was diagnosed before his death. The level of interleukin 6 (IL-6) in pericardial effusion was 16382 pg/ml, and the myeloma cells obtained from the pericardial effusion responded to IL-6, which suggested that high level of IL-6 closely related to the proliferation of myeloma cells in this case.
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PMID:[Aggressive myeloma with subcutaneous tumor and pericardial involvement]. 815 51

Restrictive cardiomyopathy from amyloid deposition within the myocardium is a well-described complication of multiple myeloma; however, myelomatous involvement of pericardium with subsequent cardiac tamponade has rarely been described. Optimal treatment for malignant involvement of the pericardium by myeloma cells has yet to be established. The following description is of a patient with myocardial and pericardial manifestations of multiple myeloma. Treatment of the malignant pericardial effusion was implemented with intrapericardial administration of bleomycin. This therapy resulted in no recurrence of pericardial effusion at nine days follow-up. Despite the absence of detectable recurrent effusion, the patient died suddenly from causes felt unrelated to pericardial disease.
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PMID:Multiple myeloma complicated by restrictive cardiomyopathy and cardiac tamponade. 844 98

High cardiac output failure/state (HCOF) is regular feature of some illnesses e.g. thiamine deficiency, hyperthyroidism, severe anemia, Paget's disease or arteriovenous fistulae. HCOF in multiple myeloma is reported quite rarely. 31-year-old man was admitted because of fatigue, dyspnea and subfebrilities. Heart rate was 116/min, sinus rythm blood pressure 110/60 mmHg. Chest film showed cardiomegaly with sings of interstitial pulmonary edema, echocardiography mild dilatation of the left ventricle with hyperkinetic wall motion and small pericardial effusion. Hemoglobin was 104 g/l, leukocyte count 13.5 x 10(9)/l with 30% of plasmatic cells. Serum protein electrophoresis demonstrated a monoclonal gammapathy, X ray studies of the skelet multiple osteolytic lesions. Diagnosis of plasmocytic leukemia-form of multiple myeloma was established and chemotherapy (vincristine + adriamycine + dexamethason) was started. Patient cardiac status deteriorated. Cardiac catheterisation demonstrated mean righ atrial pressure of 25 mmHg, mean pulmonary artery pressure of 28 mmHg and pulmonary artery wedge pressure of 24 mmHg. Co was 20.0 l/min (C.I. 11.5 l/min/m2). In continuing of chemotherapy and symptomatic therapy for heart failure patients status gradually improved and complete remission of the myeloma and normalisation of cardiac parameters was achieved. Heart failure in multiple myeloma patients has been attributed to amyloidosis of myocardium, hyperviscosity syndrome, co-existing CAD or anthracycline toxicity. HCOF should be considered in patients with clinical evidence of heart failure and normal left ventricular function.
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PMID:[Hypercirculatory heart failure in a patient with plasmacytic leukemia]. 855 97

Primary amyloidosis, due to amassing of fragments of light chains of IgG, often causes cardiac involvement. We describe a 65-year-old woman with multiple myeloma efficaciously treated with chemotherapy. Amyloidosis had been supported by myelic biopsy. The patient came to our observation because of right heart failure, hypotension and syncope: she was treated with a dopamine i.v. and was in cachectic status. She had a moderate pericardial effusion. ECG showed reduction of QRS amplitude, I degree atrioventricular block, posterior fascicular and right bundle branch block. Right cardiac catheterization showed a restrictive situation. After 1 week exitus occurred by asystole. In this case, there were other involvements by amyloidosis, besides the cardia one: that of autonomic nervous system and, probably, surrenal.
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PMID:[Case of cardiac amyloidosis associated with IgG-K multiple myeloma in the framework of restrictive myocardiopathy]. 1020 58

Pericardial involvement is a rare complication of multiple myeloma, caused by amyloidosis, infections, or plasmacell infiltration, usually at late or terminal disease stage. We report a patient with pericarditis coming from a department of Cardiology where a preceding (15 years before) diagnosis of breast cancer and present bloody pericardial effusion with probably malignant cells permitted at first to orientate towards metastatic pericardial involvement in breast cancer. Laboratory findings (pancytopenia, hypogammaglobulinemia, proteinuria) suggested to perform bone marrow aspirate, serum and concentrated urine immunoelectrophoresis, measurement of 24-h urine protein excretion, and further cytologic and immunocytochemical assay of pericardial fluid. Acquired data allowed to diagnose light chain multiple myeloma with pericardial involvement caused by plasmacell infiltration. We diagnosed this complication, representing first and main clinical feature of multiple myeloma, owing to a complete clinical and laboratory evaluation and repetition of cytologic and immunocytochemical assay of pericardial fluid.
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PMID:[Pericardial involvement as initial manifestation of multiple myeloma]. 1042 20

We report a case of IgA-kappa multiple myeloma in a 68-year-old woman that was revealed by concomitant pleural and pericardial effusion. These effusions were found to be caused by myeloma and were verified by cytological examination of the pleural fluid and pericardial biopsy. The patient had neither osteolytic lesions nor Bence-Jones proteinuria. After a pericardiocentesis, her condition improved with a melphalan and prednisolone treatment. As far as we know, such a phenomenon is rare and has never been reported yet as a way of diagnosing multiple myeloma.
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PMID:Pleural and pericardial effusion as the first sign of multiple myeloma. 1054 57

This report presents a case of multiple myeloma with a mass lesion on the pericardium and pericardial effusion. The response to intrapericardial combination chemotherapy (cisplatin and betamethasone) was evaluated by repeated transesophageal echocardiograms. Following the treatment, complete resolution of the tumor and effusion were observed for 6 months after which the patient died of bacterial pneumonia. Intrapericardial combination chemotherapy can be an effective treatment for myelomatous involvement of the pericardium.
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PMID:Transesophageal echocardiographic observation of multiple myeloma involving the pericardium: a case report. 1065 Dec 12


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