title: Multiple myeloma in a patient at risk for AIDS.
abstract: An increased incidence of tumors and B-cell lymphomas development has been reported in persons with or at risk for acquired immunodeficiency syndrome (AIDS). This report focuses on a 50-year-old homosexual man with HIV antibodies who met the established criteria for the diagnosis of multiple myeloma: an IgG monoclonal spike greater than 2 g/dl and a plasma cell count greater than 20% in the bone marrow aspirate. Serum protein immunoelectrophoresis showed monoclonal IgG kappa, and in the urine no excess of kappa chains was found. Laboratory data revealed a total IgG of 38 g/l, IgA of 5.2 g/l, and IgM of 2.3 g/l; the calcium level was normal; ESR was 119/130, and no plasmocytoid cells were seen in the differential count. No lytic lesions were found in the skeletal survey. The helper/suppressor T-cell ratio was depleted with 0.1 and HLA-DR was highly elevated with 56% in the immunofluorescent analysis. The development of the most differentiated B-cell tumor broadens the spectrum of B-cell neoplasias in patients with a predominant helper T-cell defect and focuses on the role of disordered immunoregulation and chronic antigenic stimulation in predisposing to B-cell malignant transformation associated with AIDS.
authors.affiliation: FU Klinikum Steglitz, Abteilung für Innere Medizin mit, Berlin, Federal Republic of Germany.
authors.forename: H
authors.initials: H
authors.lastname: von Keyserlingk
authors.forename: R
authors.initials: R
authors.lastname: Baur
authors.forename: H
authors.initials: H
authors.lastname: Stein
authors.forename: G
authors.initials: G
authors.lastname: Hoeffken
authors.forename: E
authors.initials: E
authors.lastname: Thiel
mesh_terms: D001853:Bone Marrow / Q000473:pathology; D006679:HIV Seropositivity / Q000097:blood / Q000150:complications* / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007145:Immunoglobulin kappa-Chains / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000150:complications* / Q000276:immunology; D009194:Myeloma Proteins / Q000032:analysis; D010950:Plasma Cells / Q000473:pathology
chemical_list: D007074:Immunoglobulin G; D007145:Immunoglobulin kappa-Chains; D009194:Myeloma Proteins