The case report of multiple myeloma and symmetric seronegative polyarthritis

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.