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)

Macroglossia and skeletal muscle enlargement with weakness appeared in a 38-year-old male who was shown to have amyloidosis and light chain multiple myeloma. Free lambda light chains were present in serum and urine. Skeletal muscle contained large amounts of amyloid and other amorphous material infiltrating blood vessel walls and connective tissue. Muscle fibers, particularly the type II variety, were diminished in size. Amyloid and similar amorphous material also were present in skin. This patient represents an unusual, but somewhat uniform, type of involvement of the neuromuscular apparatus in nonfamilial primary amyloidosis.
 ...
PMID:Skeletal muscle pseudohypertrophy in primary amyloidosis. 18 52

A 77-year-old woman with refractory multiple myeloma was treated with a 4-day continuous intravenous infusion of vincristine and doxorubicin and 4 days of oral dexamethasone. Nine days after her second cycle she presented with lethargy and weakness associated with hyponatremia. Evaluation revealed the syndrome of inappropriate secretion of antidiuretic hormone, which was attributed to the vincristine infusion. After normal serum sodium levels returned, further doxorubicin and dexamethasone chemotherapy without vincristine did not produce this complication.
 ...
PMID:Syndrome of inappropriate secretion of antidiuretic hormone after infusional vincristine. 142 76

We report a case of IgE myeloma in a 78-year-old woman who presented with bone pain in the shoulder and hip and progressive weakness. Except for hypercalcemia, routine chemistry values were within normal limits. Hemoglobin was decreased and the leukocyte count slightly increased. Plasma cells were not observed in the peripheral blood. Serum protein electrophoresis showed a monoclonal protein in the beta-globulin fraction. Immunofixation confirmed the presence of an IgE kappa monoclonal protein. A bone marrow biopsy revealed an interstitial and nodular infiltration of abnormal plasma cells comprising 60% of nucleated cells present. Skeletal roentgenograms and bone scans of this patient showed osteolytic lesions and osteopenia of the thoracic and lumbar spine and osteolytic destruction of the right half of the sacrum. Flow-cytometric analysis of mononuclear cells isolated from peripheral blood showed that 15% of the lymphocytes bound IgE. Using cell-surface markers, we identified 45% of the IgE-positive cells as natural killer cells. Similar results have been found in other diseases marked by increased IgE. The clinical, radiological, and laboratory findings for this patient are compared with previously reported cases of IgE and other types of myeloma.
 ...
PMID:A new case of IgE myeloma. 142 32

We compared the presentation features of three series of patients with multiple myeloma diagnosed between 1960 and 1971 (Kyle R, Mayo Clin Proc, 1975, 50, 29, n = 869), 1972 and 1986 (Clinica Medica, University of Pavia, n = 345) and 1987 and 1990 (Cooperative Group for Study and Treatment of Multiple Myeloma, n = 341). In the most recently diagnosed patients, the percentage of those who had symptoms related to multiple myeloma (i.e. any of bone pain, systemic symptoms, disturbances related to hypercalcemia, neurological involvement and hyperviscosity) was reduced (90 vs. 86 vs. 66%) (P less than 0.001), while the percentage of asymptomatic patients diagnosed by chance was increased (not reported, and 14 vs. 34%). In the most recent series, a lower percentage of spontaneous bone pain (68 vs. 60 vs. 37%, P less than 0.001) paralleled a lower incidence of advanced bone disease (osteolyses and pathological fractures, 60 vs. 64 vs. 34%), and renal failure (serum creatinine greater than 1.2 mg/dl) was also less common (56 vs. 44 vs. 33%, P less than 0.01), at least partially due to a decreased incidence of both hypercalcemia (30 vs. 20 vs. 18%, P less than 0.001) and of hyperuricemia (serum uric acid greater than 7 mg/dl, 47 vs. 32 vs. 26%, P less than 0.01). Systemic symptoms (weakness, infections, fever or weight loss) were reported more seldom by recently diagnosed patients, due to a decreased frequency of anaemia (haemoglobin less than 12 g/dl), leukopenia and thrombocytopenia, as well as of the systemic effects of bone pain and of renal insufficiency. These data indicate that multiple myeloma is diagnosed earlier now than in the past, and this must be taken into account when comparing survival data in treated series.
 ...
PMID:Changing clinical presentation of multiple myeloma. 183 56

Muscle involvement, usually associated with pseudohypertrophy, has been described very rarely in patients with AL-(primary or myeloma-associated) amyloidosis. Although precise mechanisms for the motor impairment in amyloid-associated muscle pseudohypertrophy are unknown, amyloid accumulation in the muscle has been thought to be a main cause of muscle weakness. We here describe a patient of amyloid-associated muscle pseudohypertrophy with IgA lambda plasma cell dyscrasia, and discuss possible mechanisms for the physical disability. The patient, a 65-year-old man, was admitted because of progressive stiffness of limb and bulbar muscles for approximately three years. On physical examination he appeared muscular and athletic. The muscles were firm with wooden or rock-like hardness. Superficial veins were engorged in all extremities. Macroglossia was marked. Resistance to passive movement was noted in all extremities with decreased range of motion; proximal joints were more severely affected. The patient walking for a short distance, his legs became heavy, tired and firm, which forced him to stop. Immunoelectrophoresis revealed the monoclonal secretion of IgA lambda in the serum and free lambda light chain in the urine. Bone marrow examination disclosed 30% plasma cells with a large prevalence of IgA lambda-containing cells. A bone scan showed an increased uptake of 99mTc-methylene diphosphate in the shoulder and pelvic joints. Tissue pressures of the quadriceps femoris at the supine and standing positions, and after walking were as high as 47, 89, and 112 mmHg, respectively. Venography of the left leg showed narrowing of the femoral vein and visualization of saphena magna vein.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Motor impairment in amyloid-associated muscle pseudohypertrophy]. 189 69

We retrospectively analyzed thirty-three patients (21 males, 12 females) with malignancy induced spinal cord compression (SCC). The mean age of the patients was 42.8 years and almost half (51%) of them presented with SCC. Mean duration of symptoms was 4.5 months and the mean interval between the original diagnosis of cancer and the development of SCC was 14.6 months. Back pain was the most frequent (97%) symptom with an equal number of patients having subjective or objective evidence of lower limb weakness. Majority (73%) of the patients were non-ambulatory at the time of diagnosis. Spinal level involvement was mostly thoracic (62%) followed by lumber (38%). Breast cancer was the commonest underlying malignancy (21%). Lung (12%), prostrate (12%), multiple myeloma (9%), and carcinoma with unknown primary (12%) were also frequently encountered. There was an overall response rate of 22% to the therapeutic interventions: mostly observed in the ambulatory patients. Only 7% of the non-ambulatory patients regained ability to walk. None of the responders had bladder or bowel dysfunction. Twenty-two percent of the responders are still ambulatory with a mean follow-up of six months.
 ...
PMID:Epidural spinal cord compression from metastatic cancer: clinical features and management. 203 83

A man with IgG1 multiple myeloma developed fever, confusion, and progressive muscle weakness resulting in paralysis. Echovirus type 11 was isolated from cerebrospinal fluid, pleura, pleural fluid, and muscle, and muscle biopsy disclosed changes consistent with viral myositis. Immunologic evaluation revealed low serum levels of polyclonal IgG subtypes 1 and 3, reduced blood levels of T-helper/inducer and T-suppressor/cytotoxic cells, and a complement abnormality involving the function of the classical pathway C3 convertase, C4b2a. Therapy with intravenous immunoglobulin was associated with clinical recovery. This is the first reported case of disseminated central nervous system enteroviral infection in an adult with a B-cell malignancy, and in association with a documented complement abnormality. The findings suggest the efficacy of immunotherapy in this disease.
 ...
PMID:Disseminated echovirus infection in a patient with multiple myeloma and a functional defect in complement. Treatment with intravenous immunoglobulin. 252 14

Ten patients with end-stage multiple myeloma refractory to conventional chemotherapy and hemibody irradiation received recombinant alpha-interferon as salvage therapy. The median duration of treatment was 8 weeks. One patient had an objective response and survived 8 months, whereas in the remaining 9 patients the disease progressed and median survival was 11.5 weeks. Side-effects were substantial and included confusion with extreme weakness, resulting in 5 patients refusing further therapy. The low response rate and the morbidity in this pilot study resulted in its discontinuation and the conclusion that recombinant alpha-interferon as single-agent therapy used for salvage in patients with refractory myeloma is of no value.
 ...
PMID:Recombinant alpha-interferon as salvage therapy in multiple myeloma. A pilot study. 276 38

From January 1984 to March 1987, eleven cases of multiple myeloma were registered in the Department of Radiotherapy, Safdarjang Hospital, New Delhi, giving an incidence of more than three cases per year. The cases had age distribution ranging 40-90 years, the youngest being 40 years and oldest 85 years. The majority were in their sixties. Majority were males. Moderate aches and pain either all over the body or confined to a region along with lethargy and weakness were the commonest presenting symptoms. Lytic bone lesions was the commonest complication. One case had cranial nerve involvement.
 ...
PMID:A profile of multiple myeloma cases (study of eleven cases). 280 36

A 76-year-old man developed a cavernous sinus syndrome as the initial manifestation of multiple myeloma. Although clinically the patient had stage IA disease, which is typically associated with a favorable response to therapy, his disease was rapidly fatal. This case emphasizes a weakness of the traditional staging system because it does not take into account certain clinical and histopathologic aspects of myeloma relevant to extramedullary plasmacytomas. Since disorders of ocular motility are more likely to be associated with extramedullary myeloma than myeloma confined to the marrow, clinicians need to be aware of the limitations in the clinical staging system and the potential problems associated with anaplastic plasmacytomas.
 ...
PMID:Cavernous sinus syndrome as the initial manifestation of multiple myeloma. 295 4


1 2 3 4 5 6 7 8 9 10 Next >>