1887
Volume 2006, Issue 2
  • ISSN: 0253-8253
  • E-ISSN: 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.

Loading

Article metrics loading...

/content/journals/10.5339/qmj.2006.2.21
2006-11-01
2019-10-15
Loading full text...

Full text loading...

References

  1. 1. Kyle   RA. . Multiple myeloma: how did it begin?.   Mayo Clin Proc . 1994; ;69: : 680– 683 .
    [Google Scholar]
  2. 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 : 275– 281 .
    [Google Scholar]
  3. 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: : 117– 132 .
    [Google Scholar]
  4. 4. Feinman   R., , Sawyer   J., , Hardin   J., , Tricot   G. . Cytogenetics and molecular genetics in multiple myeloma. . Hematol Oncol Clin North Am . 1997; ;11: : 1– 25 .
    [Google Scholar]
  5. 5. Dhodapkar   M., , Merlini   G., , Solomon   A. . Biology and therapy of immunoglobulin deposition diseases. . Hematol Oncol Clin North Am . 1997; ;11: : 89– 110 .
    [Google Scholar]
  6. 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: : 1401– 1405 .
    [Google Scholar]
  7. 7. Kyle   RA. . The monoclonal gammopathies. . Clin Chem . 1994; ;40: 11 pt 2 : 2154– 2161 .
    [Google Scholar]
  8. 8. Ravaud   P., , Thepot   C., , Auleley   GR., , Amor   B. . Imaging of multiple myeloma. . Ann Med Interne [Paris] . 1996; ;147: : 370– 375 .
    [Google Scholar]
  9. 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. 10. Dimopoulos   MA., , Moulopoulos   A., , Smith   T. , et al. , Risk of disease progression in asymptomatic multiple myeloma. . Am J Med . 1993 Jan; ;94: 1 : 57– 61 .
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.5339/qmj.2006.2.21
Loading
  • Article Type: Case Report
Keyword(s): cast nephropathy , lytic lesions , Multiple myeloma and rouleaux formation
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error