A case of xanthoma of the liver in a 61-year-old Korean woman with multiple myeloma, hyperlipidemia and xanthoma of the skin is described. Microscopically, the liver showed a multiple xanthomatous collection of foamy histiocytes as well as diffuse sinusoidal infiltration of the foam cells. This hepatic accumulation of foam cells seems to be related to hyperlipidemia of the patient. The mechanism of hyperlipidemia in multiple myeloma is discussed.
Case Report ; Female ; Human ; Hyperlipidemia/blood/*complications ; Liver Diseases/blood/*complications ; Middle Age ; Multiple Myeloma/blood/*complications ; Xanthomatosis/blood/*complications

To improve the recognition of immunoglobulin D multiple myeloma and explore its clinical feature and laboratory examination characteristics, so as to reduce the the missed diagnosis and misdiagnosis, a case of IgD multiple myeloma (MM) with myelofibrosis and bone marrow necrosis is reported. The clinical feature, treatment and prognosis of IgDlambda MM were discussed. Immunoglobulin D multiple myeloma is a rare disease and predominantly occurs in young male patients, which shows an aggressive clinical course with poor response to conventional treatment and unfavorable prognosis. Immunoglobulin D multiple myeloma was usually misdiagnosed as a light chain type multiple myeloma by using routine laboratory examination. Immunoglobulin D monoclonal protein is not easy to be detected owing to its low protein level, resulting in missed diagnosis. Immunofixation electrophoresis is highly sensitive and specific for diagnosis of IgD MM, can enhance accuracy of diagnosis for this rare disease.
Adult ; Diagnosis, Differential ; Humans ; Immunoglobulin D ; blood ; Immunoglobulin lambda-Chains ; blood ; Male ; Multiple Myeloma ; blood ; complications ; diagnosis ; Primary Myelofibrosis ; blood ; complications ; diagnosis

An 8-year-old male Austrian Pinscher and a 14-year-old male Golden Retriever were presented for evaluation due to unexplainable high fructosamine values despite euglycemia and epistaxis in combination with polydipsia/polyuria, respectively. Blood analysis revealed severe hyperglobulinemia, hypoalbuminemia and markedly elevated fructosamine concentrations in both dogs. Multiple myeloma with IgA-monoclonal gammopathy was diagnosed by serum and urine electrophoresis including immunodetection with an anti-dog IgA antibody and bone marrow aspirations. Diabetes mellitus was excluded by repeated plasma and urine glucose measurements. Fructosamine values were positively correlated with globulin, but negatively correlated with albumin concentrations. These cases suggest that, as in human patients, monoclonal IgA gammopathy should be considered as a possible differential diagnosis for dogs with high fructosamine concentrations.
Animals ; Blood Proteins/analysis ; Dog Diseases/*blood/drug therapy ; Dogs ; Fructosamine/*blood ; Immunoglobulin A/*metabolism ; Male ; Melphalan/therapeutic use ; Multiple Myeloma/complications/drug therapy/*veterinary ; Myeloablative Agonists/therapeutic use ; Paraproteinemias/blood/complications/drug therapy/*veterinary

Disorders of iron utilization caused by abnormal elevation of hepcidin levels are the main mechanism of anemia of chronic disease. Hepcidin is mainly produced by the liver. Recently it has been found that monocytes are another source of hepcidin. The increased hepcidin in serum and urine of multiple myeloma patients may be one cause of anemia of chronic disease (ACD). However it is unclear whether the peripheral blood monocyte hepcidin is involved in the pathogenesis of anemia of chronic disease. This study was purposed to investigate the role of monocyte hepcidin in multiple myeloma patients with anemia of chronic disease. The clinical data and peripheral venous blood of multiple myeloma patients were collected.Serum concentration of IL-6 and TNF-α was detected by ELISA. Peripheral blood monocytes were isolated by CD14(+) magnetic beads. Hepcidin, IL-6 and TNF-α mRNA of monocytes were detected by real time quantitative PCR. The results showed that the expression level of monocyte hepcidin mRNA in myeloma patients was higher than that in normal controls. In untreated patients, the expression level of monocyte hepcidin mRNA was negatively correlated with hemoglobin, and positively correlated with serum ferritin and IL-6 levels, but unrelated with TNF-α levels.It is concluded that the increased monocyte hepcidin levels in multiple myeloma patients may play an etiologic role in ACD.
Adult ; Aged ; Anemia ; etiology ; Case-Control Studies ; Chronic Disease ; Female ; Ferritins ; blood ; Hepcidins ; blood ; Humans ; Interleukin-6 ; blood ; Leukocytes, Mononuclear ; metabolism ; Male ; Middle Aged ; Monocytes ; metabolism ; Multiple Myeloma ; blood ; complications ; Tumor Necrosis Factor-alpha ; blood

BACKGROUND: Multiple myeloma (MM) causes the suppression of hematopoiesis because of malignant cells in the bone marrow. Thrombopoietin (TPO) is regulated by a feedback mechanism with platelets. Recently, it was suggested that an elevated TPO without thrombocytopenia was associated with impaired hematopoiesis. We evaluated whether TPO levels could be a marker for disease progression in MM. METHODS: The TPO levels were measured in 70 blood samples from 27 patients (newly/previously-diagnosed patients=13/14). We analyzed the TPO and clinical parameters, WBC, hemoglobin, creatinine, calcium, M-protein, protein, albumin, and beta2-microglobulin. The TPO in 20 healthy controls ranged from 6 to 69 pg/mL. RESULTS: The TPO levels were significantly higher in MM patients with thrombocytopenia than in patients without thrombocytopenia and the healthy controls (median TPO: 293.0 pg/mL vs 59.6 pg/mL and 35.6 pg/mL, P<0.0001). There was a negative correlation between the TPO levels and the blood cells, i.e., leukocytes (r=-0.293), hemoglobin (r=-0.378) and platelets (r=-0.508) (P<0.05). Elevated TPO were found in association with normal platelet counts (N=20). Among the samples without thrombocytopenia, especially one year after the diagnosis, the hemoglobin (10.3 vs 12.9 g/dL, P=0.025) and albumin (3.3 vs 4.0 g/dL, P=0.085) were lower and the M-protein and protein tended to be higher in patients with elevated TPO compared to those with normal TPO. CONCLUSIONS: Serum TPO was elevated with thrombocytopenia and related to impaired hematopoiesis. The elevated TPO without thrombocytopenia might be considered as impaired hematopoiesis and a marker for disease progression in patients with MM.
Aged ; Biological Markers/blood ; Blood Cell Count ; Clinical Chemistry Tests ; Disease Progression ; Female ; Hematopoiesis ; Humans ; Male ; Middle Aged ; Multiple Myeloma/*diagnosis/etiology ; Platelet Count ; Prognosis ; Retrospective Studies ; Thrombocytopenia/*blood/complications ; Thrombopoietin/*blood

Adolescent ; Adult ; Aged ; Anemia ; drug therapy ; Enzyme-Linked Immunosorbent Assay ; Erythropoietin ; blood ; therapeutic use ; Female ; Humans ; Leukemia, Lymphocytic, Chronic, B-Cell ; complications ; Lymphoma, Non-Hodgkin ; complications ; Male ; Middle Aged ; Multiple Myeloma ; complications

Antineoplastic Agents ; therapeutic use ; Back Pain ; complications ; drug therapy ; Blood Sedimentation ; Hemoglobins ; metabolism ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Multiple Myeloma ; complications ; drug therapy ; therapy ; Spondylitis, Ankylosing ; complications ; drug therapy ; Treatment Outcome

No abstract available.
Blood Cell Count ; Bone Marrow Cells/metabolism/pathology ; Humans ; Leukemia, Promyelocytic, Acute/complications/*diagnosis/pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Multiple Myeloma/complications/*diagnosis/pathology ; Paraproteinemias/diagnosis ; Syndecan-1/metabolism

OBJECTIVEIbandronate, a third generation bisphosphonate, inhibits bone resorption in human and animal studies. This study is to evaluate the efficacy and safety of ibandronate as a single agent in patients with tumor-associated hypercalcemia.

METHODSAn open, multicenter, non-controlled clinical trial was conducted in 22 patients. The patients received 2 mg ibandronate intravenously if the corrected calcium was less than 3.0 mmol/L but more than 2.7 mmol/L; they received 4 mg ibandronate iv if corrected calcium was more than 3.0 mmol/L.

RESULTSThere was 100% efficacy in these two dose groups but the calcium correcting effect was more pronounced in the 4-mg dose group than the 2-mg dose group. The most common adverse reactions were fever and skin itching with an incidence of 4.5%.

CONCLUSIONIbandronate is active in patients with tumor-associated hypercalcemia and the adverse effects are well tolerated.

Bone Neoplasms ; complications ; secretion ; Breast Neoplasms ; complications ; pathology ; Calcium ; blood ; Diphosphonates ; administration & dosage ; therapeutic use ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Female ; Fever ; chemically induced ; Humans ; Hypercalcemia ; blood ; drug therapy ; etiology ; Lung Neoplasms ; complications ; pathology ; Male ; Middle Aged ; Multiple Myeloma ; complications ; Phosphorus ; blood ; Pruritus ; chemically induced

We report a rare case of multiple myeloma with biclonal gammopathy (IgG kappa and IgA lambda type) in a 58-year-old man with prostate cancer who presented with lower back pain. Through computed tomography (CT) imaging, an osteolytic lesion at the L3 vertebra and an enhancing lesion of the prostate gland with multiple lymphadenopathies were found. In the whole body positron emission tomography-computed tomography (PET-CT), an additional osteoblastic bone lesion was found in the left ischial bone. A prostate biopsy was performed, and adenocarcinoma was confirmed. Decompression surgery of the L3 vertebra was conducted, and the pathologic result indicated that the lesion was a plasma cell neoplasm. Immunofixation electrophoresis showed the presence of biclonal gammopathy (IgG kappa and IgA lambda). Bone marrow plasma cells (CD138 positive cells) comprised 7.2% of nucleated cells and showed kappa positivity. We started radiation therapy for the L3 vertebra lesion, with a total dose of 3,940 cGy, and androgen deprivation therapy as treatment for the prostate cancer.
Adenocarcinoma/complications/*diagnosis/radiotherapy ; Antineoplastic Agents/therapeutic use ; Bone Marrow Cells/metabolism/pathology ; Combined Modality Therapy ; Humans ; Immunoelectrophoresis ; Immunoglobulin kappa-Chains/blood ; Immunoglobulin lambda-Chains/blood ; Male ; Middle Aged ; Multiple Myeloma/complications/*diagnosis/drug therapy ; Neoplasm Staging ; Positron-Emission Tomography ; Prostatic Neoplasms/complications/*diagnosis/radiotherapy ; Spine/pathology ; Syndecan-1/metabolism ; Tomography, X-Ray Computed