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)

A 53-year old woman developed slowly progressive dysarthria, mild enlargement of the tongue and dysphagia since 1 year ago. All neurological differential diagnoses that could have explained the bulbar symptoms were excluded. The swallowing sequence was pathologic and immunoglobulins were markedly reduced. A bone marrow biopsy revealed light chain myeloma grade III. Amyloid deposits were found in the tongue but not in the kidneys. Oro-pharyngeal amyloidosis was held responsible for the described complaints. It is concluded that multiple myeloma must be considered in the differential diagnosis of bulbar paralysis and that biopsy of specific lesions is necessary to confirm local amyloidosis.
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PMID:Light chain myeloma with oro-pharyngeal amyloidosis presenting as bulbar paralysis. 910 30

We have observed an increasing number of autopsies on patients with chemotherapy-related complications. One complication is toxic leukoencephalopathy, which is due to a direct toxic effect of chemotherapeutic agents on the central nervous system white matter. Autopsies of four cases of toxic leukoencephalopathy were performed following standard protocols. The brain and spinal cord were examined routinely, and histological sections were taken for evaluation. We report here three patients with hematologic malignancies and one patient with metastatic carcinoma with chemotherapy-induced leukoencephalopathy. The first was a 56-year-old male treated with multiple chemotherapeutics for multiple myeloma. He presented with confusion and focal seizures with a rapid progression to coma and decerebrate posturing. The second was a 36-year-old male who developed mental status changes, ataxia and dysarthria following treatment for lymphoma. The third was a 16-year-old male who developed a profound peripheral and central neuropathy after chemotherapy treatment for T-cell acute lymphoblastic leukemia. The fourth was a 49-year-old female patient who was treated with multiple chemotherapeutics for Stage II breast carcinoma and subsequently developed visual acuity and field defects. The neuropathologic findings in these cases, although similar, varied in severity and distribution. The white matter was affected by severe myelin pallor, edema, and a prominent macrophage infiltrate in each of the cases. The location and extent of the central nervous system pathology correlated with the type and severity of clinical symptoms. These four cases, with their varied presenting symptoms, clinical courses, and degree of pathology, emphasize the importance of considering toxic leukoencephalopathy as an etiology of acute neurologic deterioration following high-dose chemotherapy.
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PMID:Chemotherapy-induced toxic leukoencephalopathy causes a wide range of symptoms: a series of four autopsies. 1470 18

Primary central nervous system (CNS) marginal zone B-cell lymphoma (MZBL) is very rare and shows an indolent disease course with potential of being cured. It seems to originate from meningothelial cells, and the most common site of occurrence is the dura of the cerebral convexity. Primary CNS MZBL is often misdiagnosed as meningioma because of its similar tumor locations and appearances on magnetic resonance imaging (MRI). Surgery, radiation therapy, chemotherapy, and combinations of these are considered treatment modalities depending on the case. Herein, we describe an 18-year-old man who presented with acute onset of right-sided central facial nerve palsy, right-sided hemiparesis with motor power grade 4+, dizziness, and dysarthria. After an MRI scan of the brain, wherein he was first diagnosed with high-grade glioma, a biopsy sample showed that he had primary CNS MZBL arising in the left basal ganglia. He was treated with radiation therapy, which resulted in complete remission for 1 year and 10 months up to the date of this case report. It is important to diagnose primary CNS MZBL correctly because it is curable without unnecessary invasive treatment in cases of localized disease.
Clin Lymphoma Myeloma 2008 Oct
PMID:Primary central nervous system marginal zone B-cell lymphoma of the Basal Ganglia mimicking low-grade glioma: a case report and review of the literature. 1885 86

Immunomodulatory drugs (IMiDs) currently used in the treatment of multiple myeloma, are thalidomide, lenalidomide and pomalidomide. One of the most common side effects of thalidomide is neurotoxicity, predominantly in the form of peripheral neuropathy. We report 6 cases of significant central neurotoxicity associated with IMiD therapy. Treatment with thalidomide (1 patient), lenalidomide (4 patients), and pomalidomide (1 patient) was associated with various clinical manifestations of central neurotoxicity, including reversible coma, amnesia, expressive aphasia, and dysarthria. Central neurotoxicity should be recognized as an important side effect of IMiD therapy.
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PMID:Central neurotoxicity of immunomodulatory drugs in multiple myeloma. 2585 50

Multiple myeloma (MM) rarely presents with a primary neurological dysfunction, and if it does it is usually due to a plasmacytoma. This is the first case to discuss hypoglossal nerve dysfunction as the first sign of MM progression secondary to severe pathophysiologic bone lysis. A PubMed-based literature search was completed on April 17, 2016 for the terms "multiple myeloma" and "hypoglossal nerve neuropathy". A 73-year-old woman with known MM who received little treatment for several years, presented secondary to dysarthria and at first was thought to have hyperviscosity syndrome. On further examination, it was found she had light chain disease and her symptoms were secondary to severe disease progression. Imaging revealed multiple lytic lesions in the skull on skeletal survey and brain MRI revealed boney lysis near the occipital condyle and clivus likely interfering with the coursing of the hypoglossal nerve. Advanced progressing MM can cause severe boney destruction which can interfere with cranial nerve canals and cause neuropathy as a presenting symptom.
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PMID:Hypoglossal Nerve Mononeuropathy as the First Presenting Symptom of Progressing Multiple Myeloma. 2898 79