Multiple Myeloma Flashcards
Define multiple myeloma
Haematological malignancy characterised by proliferation of plasma cells and production of monoclonal Ig (paraprotein – IgG or IgA) Associated with: • Calcium ↑ • Renal failure • Anaemia • Bone disease (osteolytic)
What are the causes/risk factors of multiple myeloma?
Unknown aetiology
Multiple myeloma cells secrete Ig or Ig fragments into the serum and urine but normal Ig
production is impaired -> hypogammaglobulinaemia -> infection
• Ionising radiation
• Agricultural work
• Occupational chemical exposure e.g. benzene
What are the symptoms of multiple myeloma?
• Recurrent infections (10%)
Hypercalcaemia • Bones – pain in back, ribs • Groans – fatigue, nausea, constipation • Thrones – polyuria, polydipsia • Psychiatric moans – depression
Anaemia (70%)
• Fatigue
Bone disease (osteolytic) • Bony pain – back, ribs
Hyperviscosity
• Bleeding
• Headaches
• Visual disturbances
What are the signs of multiple myeloma?
- Carpal tunnel syndrome
- Peripheral neuropathy
Hypercalcaemia
• Dehydration
Anaemia
• Pallor
• Tachycardia
• High output murmur
What investigations are carried out for multiple myeloma?
• Bloods
- FBC – anaemia
- U&Es – renal function, high calcium, phosphate, low PTH
- Normal ALP (myeloma suppresses osteoblasts which produce ALP)
• Serum or urine electrophoresis
- Serum paraprotein (IgG and IgA)
- Urinary Bence-Jones protein (free light chains)
• Skeletal survey/bone scan