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)

Twenty autopsy cases of systemic amyloidosis, consisting of 10 cases of primary systemic amyloidosis, 6 cases of myeloma-associated amyloidosis, 2 cases of secondary amyloidosis, and 2 cases of hereditary amyloidosis, were studied clinically and pathologically with special reference to peripheral and autonomic neuropathy. The peripheral nerves of 8 cases with clinical manifestations of polyneuropathy showed deposition of amyloid in the endoneurium, capillaries within the nerve fascicles, perineurium, and epineurium with a loss and degeneration of the nerve fibers. In the peripheral nerve lesions of these cases, there appeared to be three types: I. Endoneurial deposition of amyloid--loss of unmyelinated and small myelinated fibers, II. vessel wall deposition of amyloid in the vasa nervorum--loss of large myelinated fibers; and III. a mixed type of I and II. While the peripheral nerves of 12 cases without neuropathy mainly showed deposition of amyloid in the epineurium and perineurium with well preserved nerve fibers. The possibility was considered that the pathogenesis and variety of peripheral and autonomic nerve lesions might be related to the various molecular features of amyloid proteins or their precursors in systemic amyloidosis.
 ...
PMID:Peripheral and autonomic nerve lesions in systemic amyloidosis. Three pathological types of amyloid polyneuropathy. 652 77

Amyloidosis is characterized by extracellular deposition of abnormal protein. There are six types: primary, secondary, hemodialysis-related, hereditary, senile, and localized. Primary (AL) amyloidosis is associated with monoclonal light chains in serum and/or urine with 15% of patients having multiple myeloma. Secondary (AA) amyloidosis is associated with inflammatory, infectious, and neoplastic diseases. The presentation is protean, including macroglossia, a dilated and atonic esophagus, gastric polyps or enlarged folds, and luminal narrowing or ulceration of the colon. Amyloid deposition in the gastrointestinal (GI) tract is greatest in the small intestine. The symptoms include diarrhea, steatorrhea, or constipation. Pseudo-obstruction carries a particularly grave prognosis, often not responding to pro-motility agents. Hepatic involvement is common, but the clinical manifestations are usually mild with hepatomegaly and an elevated alkaline phosphatase level. Biopsies to diagnose amyloidosis can be taken from the fat, kidney, intestine, or bone marrow. The safety of liver biopsies is controversial. With Congo Red stain, amyloid appears red in normal light and apple-green in polarized light. Treatment for AL amyloidosis is chemotherapy and stem cell transplantation; treatment for AA amyloidosis is control of the underlying disease. Amyloidosis should be considered in patients with proteinuria, cardiomyopathy, hepatomegaly (with mildly abnormal liver tests), peripheral and autonomic neuropathy, weight loss, and GI symptoms.
 ...
PMID:Gastrointestinal manifestations of amyloidosis. 1972 11

Bortezomib is a new chemotherapeutic agent approved for the treatment of relapsed/refractory and newly diagnosed multiple myeloma. One of the major side effects of bortezomib is a peripheral length-dependent sensory axonal neuropathy and, less frequently, a small fiber neuropathy. Autonomic symptoms like postural dizziness, syncope, diarrhoea, ileus, impotence and urinary disturbances have been reported, nevertheless, autonomic neuropathy has never been characterized. We describe by means of immunofluorescence, the involvement of autonomic skin nerve fibers in three patients with small fiber neuropathy induced by bortezomib treatment.
 ...
PMID:Somatic and autonomic small fiber neuropathy induced by bortezomib therapy: an immunofluorescence study. 2129 Jan 60

Peripheral neuropathy is a known side effect of bortezomib therapy. Acute autonomic neuropathy may also follow treatment with this cytotoxic agent used for treatment of multiple myeloma. Here, we report clinical characteristics and patterns of autonomic involvement in a 75-year-old patient who presented with recurring syncopes.
 ...
PMID:Bortezomib-induced severe autonomic neuropathy. 2253 74

We herein report two patients (70- and 45-year-old men) with refractory multiple myeloma who developed paralytic ileus shortly after starting bortezomib therapy. Bortezomib (1.3 mg/m(2)) was given on days 1, 4, 8, and 11 with daily oral solution itraconazole or voriconazole. Twelve and 15 days after beginning the therapy, each patient developed paralytic ileus. Interestingly, no other signs of peripheral neuropathy such as fingertip numbness were observed at the onset of ileus. Sporadic cases of paralytic ileus after bortezomib therapy have been reported, most of which developed ileus after several courses of bortezomib therapy. Our cases developed paralytic ileus shortly after initiating bortezomib, strongly suggesting that autonomic neuropathy due to bortezomib was induced by the concomitant use of itraconazole or voriconazole.
 ...
PMID:[Early onset of paralytic ileus caused by simultaneous administration of bortezomib and azole antifungals in multiple myeloma patients]. 2297 16