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)

The authors deal with the clinicopathology of the renal, alterations in light-chain disease in connection with 6 cases. The disease was recognized by the monotype (in 5 cases kappa, in 1 case lambda) immunoreactivity of the light-chain paraprotein deposited in the basal membranes of the renal tissue. Electron microscopic examinations proved the fine-granulated, electrodense character of the paraprotein. Multiple myeloma was found in 3 cases and plasma cell dyscrasia of non-tumorous characteristic in 3 cases in the background of the deposition. The renal involvement appeared clinically in the picture of proteinuria without nephrosis syndrome and in progressing azotemia. Chronic renal insufficiency developed during some months in 5 patients. Morphologically renal impairment manifested in interstitial fibrosis, tubular atrophy and ateriolar hyalinosis was seen. These were associated with different glomerular alterations, for instance in 3 cases with nodular glomerulosclerosis. In 1 patient with plasma cell dyscrasia of non-tumorous characteristic nodular glomerulosclerosis and semilunar formation was observed in 56% of the glomeruli. In an other patient with myeloma the simultaneous existence of cylinder nephropathy and light-chain nephropathy was demonstrated. Both observations are unusual phenomena in plasma cell dyscrasia.
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PMID:[Light-chain nephropathy]. 211 26

Renal complications were studied in 81 autopsied patients suffering from multiple myeloma (47 male, 34 female, mean age 66.3 years). Kidney samples were examined for the presence of Bence Jones cast nephropathy, light chain deposition disease, amyloidosis, nephrocalcinosis, chronic urate nephropathy, acute renal failure, renal vein thrombosis, acute and chronic pyelonephritis, and tumorous infiltration of the kidney tissue. Lesions were graded under the light microscope as minimal, mild, moderate or severe. This grading and the corresponding serum creatinine levels were used to distinguish four groups: 1. morphologically and functionally intact kidney (40 cases); 2. kidney involvement with good renal function (10 cases); 3. kidney involvement with moderate chronic renal insufficiency (16 cases); 4. kidney involvement with chronic uraemia (15 cases). In patients with an impaired renal function (groups 3 and 4), Bence Jones cast nephropathy occurred most frequently (27 cases, 33%); all other complications were seen much less frequently. Among the 81 patients, two cases of kappa light chain deposition disease and three cases of amyloidosis were found. Although the semiquantitative morphology and serum creatinine levels displayed a good correlation, there were cases with marked histological changes but only a moderate impairment in renal function, suggesting that the drawing of functional conclusions from morphological changes of the kidney requires caution.
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PMID:Renal complications in multiple myeloma. 248 64

In connection with the analyses of 84 post-mortem examinations (47 men, 37 women, average age: 66.3 years) the author dealt with the renal complications of multiple myeloma. The signs of cylinder nephropathy, light-chain nephropathy, amyloidosis, nephrocalcinosis, urate nephropathy, acute renal insufficiency, renal vein thrombosis, acute and chronic pyelonephritis as well as the tumorous infiltration of the renal tissue have been sought for. The severity of the lesions were ranged into minimal, slight, moderate, and severe groups. On the basis of the semiquantitative morphological picture and the clinical data: 1. intact kidney (41 patients), 2. involvement of the kidney without azotemia (10 patients), 3. involvement of the kidney with azotemia (17 patients, serum creatinine level: greater than 177 mumol/l) and 4. renal involvement with chronic renal insufficiency associated with uremia (16 patients) were discerned. In the background of 33 cases (39%) with deteriorated renal function cylinder nephropathy was found most frequently (27 occasions) (32%). Every other complication occurred significantly less frequently e.g. amyloidosis or kappa-light-chain nephropathy occurred in 3 cases each.
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PMID:[Renal complications of multiple myeloma]. 279 87

The authors report on 4 cases of acute oligo-anuric renal failure that followed intravenous urography (IVU) independently from myeloma or cardiovascular collapse. Eighty other cases can be found in the literature. Post-IVU renal failure only occurs in patients already presenting with chronic renal insufficiency, those with diabetic or geriatric arterial disease being particularly at risk. It is reversible in only one out of two cases when serum creatinine levels exceed 440 mumol/l. The various triiodide contrast media with a high osmolality are equally nephrotoxic. The pathophysiology and prevention of this complication of IVU are discussed.
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PMID:[Acute renal failure following intravenous urography. 4 cases (author's transl)]. 742 2

Renal failure is a frequent complication in multiple myeloma and it is present in about 50% of patients with newly-diagnosed multiple myeloma. Renal failure at the time of diagnosis has earlier been associated with a bad prognosis, but a better prognostic factor is the response to chemotherapy. In general, it is important to distinguish between 1) renal insufficiency at the time of diagnosis, 2) acute renal insufficiency and 3) chronic renal insufficiency developing during the course of the disease. The patients in the first two groups are treated with intensive therapy which is long-lasting (median four to six weeks). The improved function of the kidney is correlated to an improved survival. Patients developing chronic renal insufficiency late in the course of the disease should receive palliative therapy. The most important factors that provoke acute renal insufficiency are dehydration, hypercalcaemia and/or infection, but renal insufficiency is also provoked by the use of nephrotoxic drugs, hyperuricaemia and/or hyperviscosity. Chronic renal insufficiency is provoked by deposits of light chains, infiltration by plasma cells or deposits of amyloid. The treatment consists of elimination of the provoking factors and start of chemotherapy.
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PMID:[Renal insufficiency in myelomatosis. Causes and treatment]. 825 82

Baseline renal function and the renal reserve capacity were examined in 60 patients with multiple myeloma (MM). The factors leading to the development of chronic renal insufficiency (CRI) were explored through a series of conventional studies which included renal ultrasonography. In these patients, the main cause of CRI was hyper(para)proteinemia and paraproteinuria. Ultrasonography was important in determining kidney size, in evaluating the size of the renal parenchyma and calyces, and in detecting abnormalities in the urodynamics of the upper urinary tract. Plasmapheresis was shown to be an effective method for the treatment of established CRI. In addition, plasmapheresis was employed as the prophylactic therapy when abnormalities were seen on renal ultrasonography even in the absence of overt functional impairment. Plasmapheresis may be an efficient measure to protect against tubular injury and to improve the glomerular filtration rate.
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PMID:Renal insufficiency in multiple myeloma: basic mechanisms in its development and methods for treatment. 882 May 11

Six patients with multiple myeloma and chronic renal insufficiency (serum creatinine >3.0 mg/dl), including four on dialysis, received high-dose busulfan and cyclophosphamide (BUCY) followed by autologous peripheral stem cell transplantation. Peripheral blood stem cells were collected after priming with cyclophosphamide, etoposide and G-CSF. Patterns of engraftment and toxicities were not apparently different from those seen in myeloma patients with normal renal function. There was one toxicity-related death, resulting from a massive spontaneous subdural hematoma. One patient died of disease progression 6 months after transplant, while the remaining four patients are alive and free of myeloma progression 6 to 39 months after high-dose therapy. Two of these patients have remained in complete remission for 28 and 39 months. Our experience suggests that high-dose therapy with BUCY and autologous peripheral blood stem cell rescue is feasible in patients with multiple myeloma and renal failure.
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PMID:High-dose chemotherapy and autologous peripheral blood stem cell transplantation in patients with multiple myeloma and renal insufficiency. 938 28

If a patient's serum creatinine level is elevated and chronic renal insufficiency is suspected, it is important to determine whether the problem is acute or chronic; to determine the cause; to identify secondary causes (including multiple myeloma, renal vascular disease, diabetes mellitus, reflux nephropathy, stone disease with infection, and hypertension); to institute measures to slow the disease; and to control hypertension, hyperphosphatemia, and acidosis.
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PMID:Chronic Renal Failure: Determining the cause. 2122 96

The objective of our study was to interpret and discuss atypical multiple myeloma case. The article describes the case of clinical observation of a patient K, in which manifestations of chronic kidney disease and circulatory failure prevailed in clinical picture of the disease. The authors recommended an X-ray examination of skull and pelvic bones as a screening method suitable for elderly people with symptoms of chronic renal insufficiency and chronic bone and muscle pain resistant to treatment.
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PMID:Multiple myeloma: challenges of differential diagnosis (clinical case). 3212 36