title: Smoldering myeloma associated with zonisamide treatment.
abstract: A 39-year-old man was found to have hyperproteinemia after being treated with zonisamide for 10 years. Laboratory examination revealed a serum M-protein which consisted of IgG (lambda) and an increased number of plasma cells in the bone marrow, resulting in a diagnosis of smoldering myeloma. Considering his age, zonisamide was suspected to play an etiologic role in the occurrence of smoldering myeloma. Zonisamide was changed to sodium valproate. Subsequently the M-protein did not increase over 13 months. When zonisamide is used, the monitoring of serum levels of M-protein and patterns of gammaglobulin is warranted.
authors.affiliation: Department of Laboratory Medicine, Tokai University School of Medicine, Isehara, Kanagawa.
authors.forename: Satomi
authors.initials: S
authors.lastname: Asai
authors.forename: Hayato
authors.initials: H
authors.lastname: Miyachi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Tomomitsu
authors.initials: T
authors.lastname: Hotta
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Ando
mesh_terms: D000328:Adult; D000361:Agammaglobulinemia / Q000097:blood / Q000139:chemically induced*; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D004829:Epilepsy, Generalized / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007146:Immunoglobulin lambda-Chains / Q000097:blood*; D002538:Intracranial Arteriovenous Malformations / Q000150:complications; D007555:Isoxazoles / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D009101:Multiple Myeloma / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis; D009194:Myeloma Proteins / Q000032:analysis*; D013345:Subarachnoid Hemorrhage / Q000150:complications; D014635:Valproic Acid / Q000627:therapeutic use; D000078305:Zonisamide
chemical_list: D000927:Anticonvulsants; D007146:Immunoglobulin lambda-Chains; D007555:Isoxazoles; D009194:Myeloma Proteins; D000078305:Zonisamide; D014635:Valproic Acid