[A case of multiple myeloma complicated by acute transverse myelopathy due to epidural abscess].
A 51-year-old man developed fever and lumbago followed by rapidly progressive bilateral sensory disturbance below the 9th thoracic spinal cord level, flaccid paraplegia, urinary obstruction and constipation. Based on radiological examinations and laboratory findings, a diagnosis of transverse myelopathy due to epidural abscess was made. A series of MRI studies revealed multiple abscess formation in the paravertebral muscles. Hypergammaglobulinemia with M protein was observed continuously, and further examination revealed multiple myeloma in the early stage. Since it has been reported that several different immunosuppressive mechanisms precede the development of bone lesions in multiple myeloma, these mechanisms may have played an important role in the rapid progression of the abscess in this patient. Multiple myeloma is not only important as one of the disorders underlying epidural abscess of unknown etiology, but important in predisposing to severe infection as a result of the immunosuppressive mechanisms present starting in the early stage of the disease.
Sato
S
S
Department of Medicine (Neurology), Shinshu University School of Medicine, Matsumoto, Japan.
Yoshida
K
K
Matsuda
M
M
Shimada
K
K
Koh
C S
CS
Yanagisawa
N
N
D000038:Abscess / Q000150:complications* / Q000175:diagnosis; D004824:Epidural Space; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications*; D009188:Myelitis, Transverse / Q000209:etiology*; D013122:Spinal Diseases / Q000150:complications* / Q000175:diagnosis