scholarly journals Resolution of Retinal Bleeding And Exudative Retinal Detachment After Chemotherapy with Melphalan In Multiple Myeloma

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Ari Andayani ◽  
I Putu Budhiastra ◽  
I Wayan Losen Adnyana ◽  
Made Paramita Wijayati
Keyword(s):  
Multiple Myeloma ◽  
Retinal Detachment ◽  
Gamma Globulin ◽  
Plasma Cells ◽  
Exudative Retinal Detachment ◽  
Laboratory Examination ◽  
Ophthalmic Manifestations ◽  
Hematologic Cancer ◽  
Retinal Bleeding ◽  
The Right

Introduction: Multiple myeloma is the second most common hematologic cancer. It is characterized by the clonal proliferation of malignant plasma cells and associated organ dysfunction. Ophthalmic manifestations include hyperviscosity retinopathy and retinal detachment. The aim of this study is to report retinal manifestation in Multiple Myeloma. Methods: A man 45 years old, complained loss of vision on both eyes especially left eye over 1 month. He also feels weakness and 3 times spontaneous nose bleeding. His visual acquity is 6/12 on the right and 2/60 left eye with Retinal Bleeding and Retinal Detachment. His Laboratory examination result increase in WBC 65.91 x 103/µL (Neutrophil, Monocyte, Basophil and Lymphocyte) decrease RBC 3 x 106/µL, HGB 6.85 g/dL, normal PLT 193.60 103/µL, Normal Bleeding and Clotting Time and increase ESR 140 mm/hour. Multiple myeloma was diagnosed by Internal Department with bone marrow biopsy and increase of Gamma Globulin. Results: The patient was treated with melphalan 3 tablet 2 times a day and prednisone 4 mg 3 times a day for 5 days every 28 days.  After 8 month the VA 6/6 on the right and 6/10 on the left with complete resolution of on the right eye and there are resolution on the left eye with fibrosis, the laboratory examination normal WBC 3.8 x 103/µL with Neutrophil 59.3%, Monocyte 6.1 %, Eosinophil 6.3 %, Basophil 0.3 % and Lymphocyte 28.0 %, normal RBC 4.6 x 106/µL, slightly decrease HGB 12.8 g/dL, normal PLT 177.0 x 103/µL and decrease Gamma Globulin. Discussion: This case of bilateral Retinal Bleeding and Exudative Retinal Detachment are remarkable for both its presentation and response to melphalan therapy. Treatment with melphalan and prednison alone was sufficient to clear the Retinal Bleeding and restoration of Exudative Retinal Detachment. Conclusion: Complication of Multiple Myeloma can caused organ disfunction such as retinal bleeding and exudative retinal detachment. Early Diagnosis  is very crucial. In our case combination cemotheraphy with  Melphalan and Prednison showed clinically significant resolution. Workship Internal Department and Ophthalmology Department are very important for management and monitoring ophthalmology manifestation in multiple myeloma.

scholarly journals Resolution of Retinal Bleeding And Exudative Retinal Detachment After Chemotherapy with Melphalan In Multiple Myeloma

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Ari Andayani ◽  
I Putu Budhiastra ◽  
I Wayan Losen Adnyana ◽  
Made Paramita Wijayati
Keyword(s):  
Multiple Myeloma ◽  
Retinal Detachment ◽  
Gamma Globulin ◽  
Plasma Cells ◽  
Exudative Retinal Detachment ◽  
Laboratory Examination ◽  
Ophthalmic Manifestations ◽  
Hematologic Cancer ◽  
Retinal Bleeding ◽  
The Right

Introduction: Multiple myeloma is the second most common hematologic cancer. It is characterized by the clonal proliferation of malignant plasma cells and associated organ dysfunction. Ophthalmic manifestations include hyperviscosity retinopathy and retinal detachment. The aim of this study is to report retinal manifestation in Multiple Myeloma. Methods: A man 45 years old, complained loss of vision on both eyes especially left eye over 1 month. He also feels weakness and 3 times spontaneous nose bleeding. His visual acquity is 6/12 on the right and 2/60 left eye with Retinal Bleeding and Retinal Detachment. His Laboratory examination result increase in WBC 65.91 x 103/µL (Neutrophil, Monocyte, Basophil and Lymphocyte) decrease RBC 3 x 106/µL, HGB 6.85 g/dL, normal PLT 193.60 103/µL, Normal Bleeding and Clotting Time and increase ESR 140 mm/hour. Multiple myeloma was diagnosed by Internal Department with bone marrow biopsy and increase of Gamma Globulin. Results: The patient was treated with melphalan 3 tablet 2 times a day and prednisone 4 mg 3 times a day for 5 days every 28 days.  After 8 month the VA 6/6 on the right and 6/10 on the left with complete resolution of on the right eye and there are resolution on the left eye with fibrosis, the laboratory examination normal WBC 3.8 x 103/µL with Neutrophil 59.3%, Monocyte 6.1 %, Eosinophil 6.3 %, Basophil 0.3 % and Lymphocyte 28.0 %, normal RBC 4.6 x 106/µL, slightly decrease HGB 12.8 g/dL, normal PLT 177.0 x 103/µL and decrease Gamma Globulin. Discussion: This case of bilateral Retinal Bleeding and Exudative Retinal Detachment are remarkable for both its presentation and response to melphalan therapy. Treatment with melphalan and prednison alone was sufficient to clear the Retinal Bleeding and restoration of Exudative Retinal Detachment. Conclusion: Complication of Multiple Myeloma can caused organ disfunction such as retinal bleeding and exudative retinal detachment. Early Diagnosis  is very crucial. In our case combination cemotheraphy with  Melphalan and Prednison showed clinically significant resolution. Workship Internal Department and Ophthalmology Department are very important for management and monitoring ophthalmology manifestation in multiple myeloma.

scholarly journals A hematologic condition expressed as a lung disease

F1000Research ◽  
2012 ◽  
Vol 1 ◽  
pp. 28 ◽  
Author(s):  
Mónica Egozcue-Dionisi ◽  
José Nieves-Nieves ◽  
Ricardo Fernández-Gonzalez ◽  
Rosángela Fernández-Medero ◽  
Raúl Reyes-Sosa ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Pleural Effusion ◽  
Plasma Cells ◽  
Rare Complication ◽  
Disease Stage ◽  
Fluid Analysis ◽  
Progressive Dyspnea ◽  
Breath Sounds ◽  
The Right ◽  
Pleural Involvement

Pleural involvement secondary to Multiple Myeloma is considered a very rare complication. According to the literature only 1% of these patients develop a myelomatous pleural effusion. We present a case of a 39 year old man with multiple myeloma diagnosed six years prior to our evaluation, which developed progressive dyspnea, dry cough and right pleuritic chest pain two weeks prior to admission. On physical examination the patient had decreased breath sounds over the right posterior hemithorax accompanied by dullness to percussion. The chest radiogram was consistent with a right sided pleural effusion. Pleural fluid analysis revealed the presence of abundant abnormal plasma cells. The patient died four weeks after hospitalization. The presence of myelomatous pleural effusion is considered to be a poor prognostic finding, no matter at what disease stage it develops. So far no definite treatment has been shown to improve survival.

Bilateral diffuse uveal melanocytic proliferation: A case report and literature review

2020 ◽  
Author(s):  
Nianting Tong ◽  
Liangyu Wang ◽  
Nan Wang ◽  
Zhanyu Zhou
Keyword(s):  
Retinal Detachment ◽  
Exudative Retinal Detachment ◽  
Histopathologic Examination ◽  
Cataract Formation ◽  
Case Presentation ◽  
Melanocytic Tumors ◽  
Ophthalmic Manifestations ◽  
Underlying Malignancy ◽  
History Of ◽  
Shallow Anterior Chamber

Abstract Background Bilateral diffuse uveal melanocytic proliferation (BDUMP) is a rare paraneoplastic intraocular disease that causes progressive visual loss in patients driven by an IgG factor associated with an underlying malignancy. Characteristic ocular findings include exudative retinal detachment, rapid cataract formation and uveal melanocytic tumors. Case presentation Here, we presented a patient, whose clinical manifestation was diffusely thickened choroid, shallow anterior chamber, cataract formation and exudative retinal detachment. Histopathologic examination for the biopsies from the choroid during the surgery showed the the tissue might be originated from melanocytes and with the benign biologic behavior. Therefore, the diagnosis for this patient was BDUMP, although there was no obvious history of malignancy until we prepared for this article. Conclusions This was a rare BDUMP clarified by ophthalmic manifestations and histopathologic examination, without clear history of systematic malignancy.

Tooth Extraction Locally Stimulates Proliferation of Multiple Myeloma in a Patient with Mandibular Localizations

2017 ◽  
Vol 138 (4) ◽  
pp. 201-207 ◽  
Author(s):  
Jean-Daniel Kün-Darbois ◽  
Léonie Quenel ◽  
Smaïl Badja ◽  
Daniel Chappard
Keyword(s):  
Multiple Myeloma ◽  
Tooth Extraction ◽  
Soft Tissues ◽  
Plasma Cells ◽  
Osteonecrosis Of The Jaw ◽  
Surgical Trauma ◽  
Osteolytic Lesions ◽  
X Ray ◽  
Extraction Site ◽  
The Right

Objectives: Multiple myeloma (MM) is characterized by the occurrence of osteolytic lesions. MM treatment usually involves antiresorptive drugs (mainly bisphosphonates). Case Report: A patient with an MM presented osteolytic lesions of the mandible. Extraction of teeth 45 and 46 was performed 5 years after the diagnosis of periodontitis. Four months later, osteonecrosis of the jaw (ONJ) was diagnosed at the extraction site. X-ray showed an extension of osteolytic lesions on the right side, close to the extraction site, without modification of the lesions on the left side. Two months later, a curettage was performed because of a painful bone sequestration. X-ray showed an extension of the osteolytic lesions on the right side. Results: Histological analysis found a vascularized plasmacytoma of the soft tissues around the ONJ. Analysis of the bone showed mixed lesions with osteonecrotic areas and living bone resorbed by active osteoclasts surrounding a plasmacytoma. The surface area of the osteolytic foci has considerably increased only close to the extraction site. Conclusions: Tooth extraction triggered an ONJ associated with bisphosphonate treatment. However, it also seemed to induce a considerable proliferation of plasma cells at the extraction site; we hypothesize that it is due to the increase in bone remodeling related to the surgical trauma.

scholarly journals Coats’ Retinitis or Retinoblastoma in a 3-Year-Old Girl: A Case Report

Medicina ◽  
2012 ◽  
Vol 48 (4) ◽  
pp. 32
Author(s):  
Alvydas Paunksnis ◽  
Daiva Imbrasienė ◽  
Rasa Liutkevičienė ◽  
Kristina Rilienė ◽  
Evaldas Keleras ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Abnormal Development ◽  
Eye Drops ◽  
Exudative Retinal Detachment ◽  
Hard Exudates ◽  
Appropriate Treatment ◽  
Department Of Ophthalmology ◽  
Coats Disease ◽  
The Right

Coats’ disease is an idiopathic disorder defined by an abnormal development of retinal vessels with a progressive deposition of intraretinal or subretinal exudates, leading to exudative retinal detachment. The most difficult task is to differentiate Coats’ disease from retinoblastoma. We present a rare case of Coats’ disease diagnosed in a 3-year-old girl. From the age of 6 months, the girl was followed up 2 times a year at the Department of Ophthalmology, Hospital of Lithuanian University of Health Sciences, due to congenital convergent strabismus and refractive errors. At the age of 3.6 years, a routine examination of the fundus of the right eye revealed hard exudates, telangiectasia and tortuosity, gray color lesion below the optic nerve disc, submacular exudation in the inferior nasal part of the retina, and exudative retinal detachment, which extended from the 7-o’clock position to the 4-o’clock position. Before this examination, no abnormalities were found in the fundus of her both eyes. The girl was not treated with laser photocoagulation, cryocoagulation, or intravitreal injections, as the diagnosis of retinoblastoma could not be excluded; therefore, only eye drops were prescribed. In order to exclude the diagnosis of retinoblastoma, ultrasonography, magnetic resonance imaging, and computed tomography were carried out, and an appointment to see an ophthalmic oncologist was scheduled. Due to early and appropriate treatment, the progression of Coats’ disease in patients could be arrested. However, in some cases, when the diagnosis is ambiguous, it is better to follow up the patient and to treat only with eye drops.

scholarly journals Maxillary Swelling as the First Evidence of Multiple Myeloma

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Atsushi Kasamatsu ◽  
Yasushi Kimura ◽  
Hideki Tsujimura ◽  
Harusachi Kanazawa ◽  
Nao Koide ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Plasma Cells ◽  
Malignant Neoplasm ◽  
Magnetic Resonance Images ◽  
Oral Manifestations ◽  
Tissue Mass ◽  
Old Japanese ◽  
Single Clone ◽  
Buccal Space ◽  
The Right

Multiple myeloma is a malignant neoplasm of plasma cells characterized by proliferation of a single clone of abnormal immunoglobulin-secreting plasma cells. Since the amount of hemopoietic bone marrow is decreased in the maxilla, oral manifestations of multiple myeloma are less common in the maxilla than in the mandible. We report the case of 33-year-old Japanese man who presented with a mass in the right maxillary alveolar region. Computed tomography and magnetic resonance images showed a soft tissue mass in the right maxilla eroding the anterior and lateral walls of the maxillary sinus and extending into the buccal space. The biopsy results, imaging, and laboratory investigations led to the diagnosis of multiple myeloma. This case report suggests that oral surgeons and dentists should properly address oral manifestations as first indications of multiple myeloma.

scholarly journals Multi-omics tumor profiling technologies to develop precision medicine in multiple myeloma

2021 ◽  
Author(s):  
Sara Ovejero ◽  
Jerome Moreaux
Keyword(s):  
Multiple Myeloma ◽  
Plasma Cells ◽  
Gene Mutations ◽  
Biological Data ◽  
Response To Treatment ◽  
Omics Technologies ◽  
Hematologic Cancer ◽  
Great Heterogeneity ◽  
Causes Of Mortality ◽  
Therapeutic Decision Making

Multiple myeloma (MM), the second most common hematologic cancer, is caused by accumulation of aberrant plasma cells in the bone marrow. Its molecular causes are not fully understood and its great heterogeneity among patients complicates therapeutic decision-making. In the past decades, development of new therapies and drugs have significantly improved survival of MM patients. However, resistance to drugs and relapse remain the most common causes of mortality and are the major challenges to overcome. The advent of high throughput omics technologies capable of analyzing big amount of clinical and biological data has changed the way to diagnose and treat MM. Integration of omics data (gene mutations, gene expression, epigenetic information, and protein and metabolite levels) with clinical histories of thousands of patients allows to build scores to stratify the risk at diagnosis and predict the response to treatment, helping clinicians to make better educated decisions for each particular case. There is no doubt that the future of MM treatment relies on personalized therapies based on predictive models built from omics studies. This review summarizes the current treatments and the use of omics technologies in MM, and their importance in the implementation of personalized medicine.

scholarly journals Multi-omics tumor profiling technologies to develop precision medicine in multiple myeloma

2021 ◽  
Author(s):  
Sara Ovejero ◽  
Jerome Moreaux
Keyword(s):  
Multiple Myeloma ◽  
Plasma Cells ◽  
Gene Mutations ◽  
Biological Data ◽  
Response To Treatment ◽  
Omics Technologies ◽  
Hematologic Cancer ◽  
Great Heterogeneity ◽  
Causes Of Mortality ◽  
Therapeutic Decision Making

Multiple myeloma (MM), the second most common hematologic cancer, is caused by accumulation of aberrant plasma cells in the bone marrow. Its molecular causes are not fully understood and its great heterogeneity among patients complicates therapeutic decision-making. In the past decades, development of new therapies and drugs have significantly improved survival of MM patients. However, resistance to drugs and relapse remain the most common causes of mortality and are the major challenges to overcome. The advent of high throughput omics technologies capable of analyzing big amount of clinical and biological data has changed the way to diagnose and treat MM. Integration of omics data (gene mutations, gene expression, epigenetic information, and protein and metabolite levels) with clinical histories of thousands of patients allows to build scores to stratify the risk at diagnosis and predict the response to treatment, helping clinicians to make better educated decisions for each particular case. There is no doubt that the future of MM treatment relies on personalized therapies based on predictive models built from omics studies. This review summarizes the current treatments and the use of omics technologies in MM, and their importance in the implementation of personalized medicine.

scholarly journals Multiple myeloma associated with IgA lambda gammopathy and multiple myeloma oncogene 1 in a Yorkshire terrier

2018 ◽  
Vol 63 (No. 4) ◽  
pp. 187-192
Author(s):  
S. Kim ◽  
E. Son ◽  
S. Lee ◽  
S. Lee ◽  
H. Kim ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Plasma Cells ◽  
Weight Bearing ◽  
Serum Biochemistry ◽  
First Case ◽  
History Of ◽  
Immunofixation Electrophoresis ◽  
The Right ◽  
Yorkshire Terrier

An eight-year-old spayed female Yorkshire terrier was presented with a one-month history of conspicuous weight-bearing lameness in the right hindlimb, mild anorexia, intermittent vomiting and marked polydipsia and polyuria. Radiographs revealed circular radiolucent foci of variable size in the skeleton. Haematological and serum biochemistry examination revealed mild leucopoenia with severe neutropaenia, mild non-regenerative anaemia, moderate thrombocytopoenia, moderate hyperglobulinaemia, mild hypoalbuminaemia, mild azotaemia and moderate hypercalcaemia. Quantification of serum immunoglobulins revealed elevated IgA and IgG. Serum protein electrophoresis showed a broad appearance with a β-region spike. Plasma cells accounted for 7.6% of the cells in the bone marrow. Serum immunofixation electrophoresis (IFE) revealed IgA lambda gammopathy. Immunohistochemistry in the bone marrow was diffusely positive for multiple myeloma oncogene 1 (MUM-1) and CD20. To our knowledge, this is first case report of multiple myeloma associated with IgA lambda gammopathy confirmed via IFE and immunohistochemical expression of MUM-1 in a dog.

Biologic variations of plasma cells in the bone marrow of smoldering multiple myeloma (SMM) and multiple myeloma (MM) patients: Multiple biopsies in the same patient.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e19506-e19506
Author(s):  
Elisabet E. Manasanch ◽  
Neha Korde ◽  
Constance Yuan ◽  
Mary Kwok ◽  
Nishant Tageja ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Plasma Cells ◽  
Ethylenediaminetetraacetic Acid ◽  
Rank Test ◽  
Phenotypic Analysis ◽  
Multiple Biopsies ◽  
Treatment Naïve ◽  
The Right ◽  
Cd Markers

e19506 Background: The European Myeloma Network has reported that plasma cell (PC) enumeration by flow cytometry (FC) varies depending on quality of aspirate pull and field biopsied. We conducted a prospective study to evaluate PC site variation content in the core biopsy (CB), PC viability (V) and proportion of monoclonal PCs based on immunophenotypic characteristics, anticoagulant use, and aspirate (A) pull sequence in SMM and MM treatment-naïve patients. Methods: Untreated SMM (n=5) and MM (n=5) patients underwent bilateral bone marrow (BM) A and CB. Bilateral first-pull A were anticoagulated with ethylenediaminetetraacetic acid (EDTA). The second-pull A were anticoagulated with heparin. CB were performed after obtaining all A. The first pull A was sent for morphology and FC evaluation, and the second-pull for FC. CB infiltration by PC was assessed by CD138 immunohistochemistry (IHC). Analysis of PC by FC used CD markers: 19, 45, 20, 38, 138, 27, 28, 19, 81, 126, 200 and 117. V was measured by FC using 7-amino-actinomycin D exclusion. We used the two-tailed Wilcoxon signed rank test to determine the significance of the difference between paired values. Results: The mean difference in estimated percentage of PC infiltration between the right and left CB was 0.033 +/- 0.017 (p=0.25). Phenotypic analysis of PCs by FC showed similar expression of CD markers. PC V was significantly lower in samples anticoagulated with EDTA when compared to heparin (p<0.005), suggesting that the latter is superior for PC analysis. Of importance, the fraction of abnormal PCs determined by FC did not differ significantly between the two sides, use of EDTA/heparin or order of A pull (p>0.05). Conclusions: Based on IHC and FC, our results suggest that in untreated patients with SMM or MM there are no major differences in the estimated number or immunophenotypic characteristics and distribution of PC in marrow samples obtained from two distant bone sites. These observations have implications for current diagnostic and treatment of MM and its precursor disease. More advanced molecular profiling may find biological variation in bone marrow tumor PC extracted from different locations.

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