An unusual presentation of multiple myeloma: A case report

被引:13
作者
Molloy C.B. [1 ,2 ]
Peck R.A. [2 ]
Bonny S.J. [3 ]
Jowitt S.N. [3 ,4 ]
Denton J. [5 ]
Freemont A.J. [5 ]
Ismail A.A. [2 ]
机构
[1] Department of Rheumatology, St. Michaels Hospital, Toronto, ON
[2] Department of Rheumatology, Stockport NHS Trust, Stockport
[3] Department of Haematology, Stockport NHS Trust, Stockport
[4] Department of Haematology, Salford Royal NHS Trust, Salford
[5] Department of Osteoarticular Pathology, Manchester University, Manchester
关键词
Multiple Myeloma; Myeloma; Carpal Tunnel Syndrome; Plasma Cell Dyscrasia; Erosive Arthritis;
D O I
10.1186/1752-1947-1-84
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摘要
Multiple myeloma can occasionally manifest with joint disease. We report the case of an individual with a progressive bilateral carpal syndrome and a symmetrical severe seronegative polyarthritis and joint swelling. Investigations revealed an erosive seronegative inflammatory arthritis in association with bilateral carpal tunnel syndrome, anaemia, hepatic impairment and nephrotic-range proteinuria. Synovial fluid cytology demonstrated plasmablasts and multinucleated cells with products of chondrolysis. The diagnosis of multiple myeloma (with secondary amyloidosis) was made on serum protein electrophoresis and bone marrow biopsy. The relationship between myeloma and joint disease is discussed, highlighted by the presence in this case of all three pathogenic features associated with arthritis in myeloma patients- an erosive arthritis, carpal tunnel syndrome and an invasive tumoural arthritis. © 2007 Molloy et al; licensee BioMed Central Ltd.
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共 9 条
[1]  
Jorgensen C., Guerin B., Ferrazzi V., Bologna C., Sany J., Arthritis associated with monoclonal gammopathy: Clinical characteristics, Br J Rheumatol, 35, pp. 241-243, (1996)
[2]  
Vitalli C., Baglioni P., Vivaldi I., Cacialli R., Tavoni A., Bombardieri S., Erosive arthritis in monoclonal gammopathy of unknown significance: Report of four cases, Arthritis Rheum, 34, pp. 1600-1605, (1991)
[3]  
Roux S., Fermand J.P., Brechignac S., Mariette X., Kahn M.F., Brouet J.C., Tumoral joint involvement in multiple myeloma and Waldenströms macroglobulinaemia- report of 4 cases, J Rheumatol, 23, pp. 2175-2178, (1996)
[4]  
Langlands D., Dawkins R., Matz I., Arthritis associated with a crystallizing cryoprecipitable IgG paraprotein, Am J Med, 68, pp. 461-465, (1980)
[5]  
Wiernik P., Amyloid joint disease, Medicine (Baltimore), 51, pp. 465-478, (1972)
[6]  
Evans T., Nercessian B., Sanders K., Leukaemic arthritis, Arthritis Rheum, 24, pp. 48-56, (1994)
[7]  
Rice D., Semble E., Ahl E., Bohrer S., Rothberger H., Primary lymphoma of bone presenting as monoarthritis, J Rheumatol, 11, pp. 851-854, (1984)
[8]  
Villiaumey J., Larget-Piet B., Pointud P., Les complications articulaires de la maladie de Kahler. Résultats d'une enquête portant sur 1953 dossiers de myélomes plasmocytaires, Rev Rhum Mal Osteoartic, 42, pp. 25-34, (1975)
[9]  
Durie B.G.M., Salmon S.E., A clinical staging system for multiple myeloma. Correlation of measured myeloma cell mass with presenting clinical features, response to treatment and survival, Cancer, 36, pp. 842-854, (1975)