1887
Volume 2006, Issue 2
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

A 68-year-old gentleman with a long history of type 2 diabetes mellitus and recurrent multidrug resistant urinary tract infection and a recent history of a carbuncle, presented with a one week history of fever and dysuria. Laboratory results included erythrocyte rouleaux formation, ESR 121 mm/h, creatinine 217umol/l, total protein 83 g/l, albumin 32g/l, and Bence-Jones protein in the urine. Skull X-ray showed multiple lytic lesions. Serum protein electrophoresis showed a monoclonal band of33g/ I of IgA kappa, IgG 665 mg/dl, and IgM 26.9 mg/dl. Bone marrow aspirate showed an infiltration of plasma cells. Renal biopsy showed a mild cast nephropathy with mild diabetic glomerular disease. The patient was assessed as stage IIIB multiple myeloma IgA kappa type and was started on chemotherapy MP protocol (oral Melphalan 5 mg/sq m body surface area plus oral prednisolone 60mg/sq m body surface area for four days every four weeks) after which he became stable.

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/content/journals/10.5339/qmj.2006.2.21
2006-11-01
2024-11-03
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References

  1. Kyle RA. Multiple myeloma: how did it begin? Mayo Clin Proc. 1994; 69::680683.
    [Google Scholar]
  2. Walker B, Figgs LW, Zahm SH. Differences in cancer incidence, mortality, and survival between African Americans and whites. Environ Health Perspect. 1995; 103:suppl 8:275281.
    [Google Scholar]
  3. Cardis E, Gilbert ES, Carpenter L, Howe G, Kato I, Armstrong BK, et al., Effects of low doses and low dose rates of external ionizing radiation: cancer mortality among nuclear industry workers in three countries. Radiat Res. 1995; 142::117132.
    [Google Scholar]
  4. Feinman R, Sawyer J, Hardin J, Tricot G. Cytogenetics and molecular genetics in multiple myeloma. Hematol Oncol Clin North Am. 1997; 11::125.
    [Google Scholar]
  5. Dhodapkar M, Merlini G, Solomon A. Biology and therapy of immunoglobulin deposition diseases. Hematol Oncol Clin North Am. 1997; 11::89110.
    [Google Scholar]
  6. Riccardi A, Gobbi P, Ucci G, Bertoloni D, Luoni R, Rutigliano L, et al., Changing clinical presentation of multiple myeloma. Eur J Cancer. 1991; 27::14011405.
    [Google Scholar]
  7. Kyle RA. The monoclonal gammopathies. Clin Chem. 1994; 40:11 pt 2:21542161.
    [Google Scholar]
  8. Ravaud P, Thepot C, Auleley GR, Amor B. Imaging of multiple myeloma. Ann Med Interne [Paris]. 1996; 147::370375.
    [Google Scholar]
  9. Bataille R., Harousseau J: Multiple Myeloma-Review Article. The New England Journal Medicine, June 5, 1997, Volume 336, Number 23, pg 1657-1664.
  10. Dimopoulos MA, Moulopoulos A, Smith T, et al., Risk of disease progression in asymptomatic multiple myeloma. Am J Med. 1993 Jan; 94:1:5761.
    [Google Scholar]
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  • Article Type: Case Report
Keyword(s): cast nephropathylytic lesionsMultiple myeloma and rouleaux formation
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