[Multiple myeloma presenting as massive ascites].
Ascites is a rare complication of multiple myeloma. We report a case of multiple myeloma with peritoneal involvement. An 80-year-old woman was admitted to our hospital because of massive ascites. Laboratory findings included an Hb of 7.8 g/dl, IgA of 2,160 mg/dl, and CA125 of 942 IU/ml. Immunoelectropheresis analysis detected a monoclonal component of IgA lambda in serum, and of BJP lambda in urine. Bone marrow aspirtion revealed normal cellularity with 32.7% atypical plasma cells. The ascites was characterized by an exudate with numerous atypical plasma cells and elevated IgA and CA125 levels. The IL-6 level was 22 pg/ml and 79 pg/ml in serum and ascites, respectively. A diagnosis of IgA lambda multiple myeloma with peritoneal involvement was made. Chemotherapy consisting of melphalan and prednisolone reduced the serum IgA and CA125 levels markedly, and alleviated the patient's ascites.
Shimizu
M
M
First Department of Internal Medicine, Gifu University School of Medicine.
Tsurumi
H
H
Hara
T
T
Fukutomi
Y
Y
Moriwaki
H
H
D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000209:etiology*; D005260:Female; D006801:Humans; D009101:Multiple Myeloma / Q000150:complications*