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)

62-year-old female, who had been under observation for an indolent myeloma for six years without therapy, was admitted because of left flank pain. Various imaging modalities disclosed left pleural effusion, and a huge abdominal tumor involving the left crus of the diaphragm, spleen, stomach, pancreatic tail, left adrenal gland, left kidney and left posterior abdominal wall. Morphological and immunological examinations revealed extensive proliferation of more anaplastic myeloma cells within the tumor and in the pleural effusion than those in bone marrow on admission or at the beginning of the period of observation. Chemotherapy reduced serum M-protein, but LDH, the volume of the pleural effusion, and the size of the tumor increased. She died of pancreatitis associated with massive bleeding from the gastric tumor. Renal function was well preserved until her terminal phase. The clinical course showed the progression of indolent myeloma into an aggressive one without chemotherapeutic intervention, implying a rare subtype in terms of the natural history of multiple myeloma.
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PMID:[Aggressive transformation of an indolent myeloma with abdominal extramedullary plasmacytoma after 6-year period of observation]. 802 86

A percutaneous renal biopsy is the diagnostic procedure of choice in a variety of renal diseases. Although the risk is generally minimal, serious complications can rarely occur. Here we present the case of a 50-year-old male with renal amyloidosis due to myeloma, who suddenly developed left flank pain after a percutaneous renal biopsy. Imaging studies revealed a renal infarction with an intraluminal thrombus in the left wall of the descending aorta. Subsequent arterial thromboembolic events in the left limb followed immediately after the femoral arteriography. Arterial thromboembolism is a relatively rare, serious, unexpected and multifactorial event that occurs during an exacerbation of the nephrotic syndrome. In this case, the arterial vascular trauma from the renal biopsy and arterial puncture for angiography might have increased the risk for the thrombotic episode that resulted in death. Therefore, a thorough assessment for the risk factors prior to an invasive procedure such as a renal biopsy should be required so that patients at high risk can be identified.
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PMID:Renal infarction and rapidly progressive arterial thromboembolism following a percutaneous renal biopsy. 2190 74

Extramedullary plasmacytoma (EMP) is a rare malignant tumor that is characterized by a malignant plasma cell neoplasm. Such neoplasms in human immunodeficiency virus (HIV)-infected patients are extremely rare. To the best of our knowledge, the present study describes the first case of a solitary adrenal EMP in a patient with HIV. A 35-year-old male who had been diagnosed with HIV 3 months previously presented with a 2-week history of intermittent right flank pain. Abdominal computed tomography revealed a soft-tissue density mass in the right adrenal gland area. The patient subsequently underwent a retroperitoneal laparoscopic adrenalectomy. Post-operative pathological diagnosis revealed a solitary EMP. Although the patient refused to undergo post-operative radiotherapy and chemotherapy, no recurrence was detected after 2 years of follow-up. The present case illustrates the fact that this rare type of solitary EMP associated with acquired immune deficiency syndrome (AIDS) can occur in the adrenal glands, and that retroperitoneal laparoscopic resection of the tumor may be a good method to manage this condition. In addition, although rare, solitary EMP should be considered in the differential diagnosis of an adrenal mass in HIV-infected patients.
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PMID:Retroperitoneal laparoscopic management of a solitary extramedullary plasmacytoma associated with human immunodeficiency virus infection: A case report. 2687 Feb 81

Plasmacytomas are rare immunoproliferative monoclonal plasma cell diseases of lymphoid lineage that may present in an isolated or systemic manner. Systemic involvement is much more common than occurrences isolated to a particular organ, and for this reason, it is imperative to rule out systemic involvement for osseous and nonosseous isolated neoplasms. These neoplasms present unique challenges due to their location, extent of involvement, vague presentation, and dearth of treatment protocol. We report the case of a 69-year-old man who developed chronic kidney disease stage 4 between 2009 and 2012. Precipitous kidney failure, anorexia, fatigue, and flank pain necessitated clinical follow-up that ultimately led to thorough imaging and bilateral kidney biopsy. Protein electrophoresis, immunohistochemistry, and immunofluorescence were all consistent with bilateral renal extramedullary plasmacytomas. Treatment recommendations are often limited to prior case successes; however, chemotherapy, radiation, and surgery are the mainstay of treatment. Although surgery or combined therapy provides the best results for patients, such options are unfeasible with bilateral kidney involvement. Therefore, a chemotherapy regimen, similar to that for multiple myeloma, was determined to be most reasonable. Treatment consisted of 4 cycles of a bortezomib, cyclophosphamide, and dexamethasone regimen. Three months following chemotherapy, kidney function returned to baseline levels.
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PMID:Clinical Course of a Patient With Kidney Failure Due to Isolated Bilateral Renal Extramedullary Plasmacytomas. 2988 24

Tuberculosis (TB) remains a worldwide scourge and the most common cause of mortality from infectious disease. Around 95% of cases occur in developing country. Renal TB is a rare cases that complicates 3-4% of pulmonary TB patients and commonly overlooked in clinical practice due to its symptoms may mimic other diseases.A-39-year-old man was admitted to our institution due to flank pain. He had history of low grade fever and oligouria since 5 months prior. He had no complaint of cough, dyspnea, or night sweat. He was a non smoker and had no past medical history of tuberculosis. Previous 4 months abdominal ultrasound showed left pelvocaliectasis and ureteral dilatation with suspicion of left ureteral stenosis. Ureterolithiasis could not be excluded. No prostate enlargement or vesicolithiasis was seen. Intravenous pyelography (IVP) examination demonstrated similar finding. Initial laboratory blood examination showed anemia (10.7 g/dl), leukocytosis (14,080/ul), increased in serum creatinin (4.2 mg/dl), ureum (227 mg/dl), and calcium (6.78 mg/dl). Serology examinations were negative for HIV, HBsAg, anti HCV and blood culture had no growth. Urinary examination revealed severe leucocyturia, hematuria, and negative for bacteria, nitrite and cast. Urine culture was positive for Candida glabrata. Pulmonary X-ray suggested right pleural fibrotic. He was initially diagnosed as multiple myeloma with fungal infection. Nevertheless, additional peripheral blood smear showed neither rouleaux formation nor blast. He underwent percutaneous nephrostomy and got micafungin intravenously. Instead of improving, the patient deteriorated and transferred to intensive room. We then explored the possibility of TB infection. Further examination revealed positive for Mycobacterium tuberculosis in urinary polymerase chain reaction (PCR) test. Tracheal sputum examination was positive for acid fast bacilli staining. There was low level of serum vitamin D2 (5.8 ng/ml). He got TB treatment with rifampicin, isoniazid, pyrazinamide, and ethambutol. Unfortunately, the patient eventually succumbed.
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PMID:Renal Tuberculosis: The Masquerader. 3204 21