The case report of multiple myeloma and symmetric seronegative polyarthritis

Клинический случай множественной миеломы и симметричного серонегативного полиартрита
Tuba Tülay Koca 1
More Detail
1 Malatya State Hospital, Physical Medicine and Rehabilitation Clinic, Turkey
J CLIN MED KAZ, Volume 2, Issue 36, pp. 34-38.
OPEN ACCESS 3141 Views 2167 Downloads
Download Full Text (PDF)

ABSTRACT

Multiple Myeloma (MM) is a malignant proliferation of plasma cells producing monoclonal proteins. MM may manifest as skeletal pain, pathological fractures, fatigue, anemia, infection, hypocalsemia, spinal cord compression or renal failure. Proliferating plasma cells are responsible for these clinical symptoms. Seronegative erosive poly/olygoarthritis may be observed in patients with MM and other monoclonal gammopathies concurrently at the time of diagnosis, after the diagnosis or occasionally before it. The patient admitted to hospital in May 2012 with the complaint of fatigue, polyarthralgia, limitation of hand joints’ movements. Her physical examination revealed flexion contractures in elbows, fingers, knee, feet joints bilaterally. Laboratory examination revealed a sedimentation rate of 106 mm/h; rheumatoid factor(RF), C-reactive protein(CRP) and anti-cyclic citrullinated peptide(anti-CCP) was negative and anti nuclear antibody(ANA) tested by immunfluorescence technique was positive. The patient is considered and followed up as an inflammatory arthritis developed in MM process. The joint involvements were symmetric, erosive pattern and seronegative tested. The diseases with monoclonal gammopathies may lead to erosive polyarthritis or olygoarthritis so we should investigate the immunopathogenesis of arthritis process.

CITATION

Koca TT. The case report of multiple myeloma and symmetric seronegative polyarthritis. Journal of Clinical Medicine of Kazakhstan. 2015;2(36):34-8.

REFERENCES

  • Rajkmar SV. Multiple Myeloma: 2012 update on diagnosis, risk-stratification, and management, J. Heamatology, 2012, No.87(1), pp.78-88.
  • Jargessen C, Guerin B, Ferrari V. Arthritis assosiation with monoclonal gammopathy’s clinical characteristics, Br J Rheumol, 1996, No.35, pp.241-243.
  • Molley C., Peck R., Banry S. An unusual presentation of Multiple Myeloma: a case report, J. Med, 2007, No.1, pp.84-87.
  • Vitalli C, Baglioni P, Vivaldi I. Erosive arthritis in monoclonal gammopathy of unknown signifigance: report of four cases, Arthitis Rheum, 1991, No.34, pp.1600-1605.
  • Agorwal D, Sharma A, Kapoor S. Multiple Myeloma presenting with musculoskeletal manifestations: A case report, Int J Rheumon Dis, 2010, No.13(3), pp.242-245.
  • Wadhera RK, Kyle RA. Incidence, clinical course and prognosis of secondary monoclonal gammopathy of undetermined significance in patients with Multiple Myeloma, Blood, 2011, No.118(11), pp.2985-2987.
  • Malley C., Pech R., Banry S. An unusual presentation of multiple myeloma: a case report, J Med, 2007, No.1, p.84.
  • Rado MS, Podor K, Breitkreuz I. MM Lancet. 2009, No.374(9686), pp.324-339.
  • Alpay N, Artim-Esen B, Kamali S. Amyloid artropathy mimicing seronegative rheumatoid arthritis in multiple myeloma: case reports and review of litherature, Amyloid, 2009, No.1614, pp.226-231.
  • Roca F, Lantant Weybel K. AL amyloidosis with myeloma mimicing rheumatoid arthritis, Joint Bone Spine, 2011, No.78(2), pp.215-216.
  • Hank H, Teitelbaum A, Kaura S. Evoluation of clinical benefit of long term (beyond 2 years) treatment of skeletal related events in advanced cancers with zolendronic acid, Curn. Med. Des. Opin, 2012, No.28(7), pp.1119-1127.
  • Morgan G.J. Effects of induction and maintenance plus long term bifosfonate on bone diseases in patients with multiple myeloma, Blood, 2012, No.119 (23), pp.5374-5383.
  • Schütz N, Marker–Herman E. Rheumoid Arthritis and MM as comorbidity. İs Tocilizumab a therapy option? Z. Rheumatol, 2012, No.71(1), pp.78-82.
  • Parades-Suarez C, Fernandez-Redendo V. Multiple Myeloma with Scleroderma like changes, J Eur Acad Dermatol Venereol, 2005, No.19(4), pp.500-502.