Multiple myeloma with primary amyloidosis presenting with digestive symptoms: A case report and literature review |
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| Affiliation: | 1. Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases, Yong’an Road, No. 95, Beijing 100050, China;2. Department of Hematology, Beijing Friendship Hospital, Capital Medical University, Yong’an Road, No.95, Beijing 100050, China;1. Department of Chemical Pathology, Medical Research Institute, Alexandria University, Egypt;2. Department of Experimental and Internal Medicine, Medical Research Institute, Alexandria University, Egypt;3. Ministry of Health - Lab Specialist, Egypt;1. Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt;2. Clinical Oncology Department, Faculty of Medicine, Helwan University, Cairo, Egypt;3. Tropical Medicine and Gastroenterology Department, Faculty of Medicine, Assiut University, Assiut, Egypt;1. Department of Public Health, Shaanxi University of Chinese Medicine, China;2. Department of Pathology, Shaanxi University of Chinese Medicine, China;1. Department of Paediatric Gastroenterology, Cerrahpasa Medical School, Istanbul University, Turkey;2. Paediatric Rheumatology, Cerrahpasa Medical School, Istanbul University, Turkey;1. Internal Medicine, Health Radiation Research Department, National Center for Radiation Research and Technology, Atomic Energy Authority, Cairo, Egypt;2. Clinical Pathology, Health Radiation Research Department, National Center for Radiation Research and Technology, Atomic Energy Authority, Cairo, Egypt |
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| Abstract: | We present a case of multiple myeloma with primary systemic amyloidosis presenting with digestive symptoms in a 32-year-old male. Initial symptoms included upper abdominal discomfort for 4 months, and stool with mucous and blood for 1 month. Erosive gastritis, Helicobacter pylori infection, haematochezia, and weight loss were noted, but without bone pain, anaemia, or hypercalcaemia. Bone marrow examination showed 18.5% mature monoclonal plasma cells that were λ light chain protein and CD38 positive. Three courses of 28-day PTD therapy (i.e., bortezomib, dexamethasone, and thalidomide) were administered. Gastrointestinal symptoms and laboratory parameters improved. Post-treatment follow-up showed 0.5% plasma cells with normal morphology in bone marrow, urine λ light chain 10.1 mg/L, and negative M protein. Nevertheless, the patient died of multiple organ system failure 8 months after treatment.ConclusionsAmyloidosis is an uncommon finding in patients with multiple myeloma, especially in younger individuals. |
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| Keywords: | Multiple myeloma Primary amyloidosis Digestive symptoms Monism PTD treatment |
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