title: Case of multiple myeloma mimicking an infectious disease with fever, intrahepatic cholestasis, renal failure, and pulmonary insufficiency.
abstract: We describe a case of multiple myeloma (MM) presenting with high fever, inflammatory chemistry abnormalities, simultaneous acute renal failure, cholestatic hepatitis, and acute lung failure. The extremely aggressive course and pulmonary involvement in the form of pulmonary alveolar proteinosis (PAP) are discussed, stressing the unusual nature of the findings and the variable picture of MM.
authors.affiliation: Dipartimento di Clinica Medica, Immunologia e Malattie Infettive, University of Bari, Policlinico, Bari, Italy. diceglie@intmed.uniba.it
authors.forename: Francesco S
authors.initials: FS
authors.lastname: Vella
authors.forename: Barbara
authors.initials: B
authors.lastname: Simone
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Giannelli
authors.forename: MariaTeresa
authors.initials: M
authors.lastname: Pesolo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ingravallo
authors.forename: Antonia
authors.initials: A
authors.lastname: Gentile
authors.forename: Salvatore
authors.initials: S
authors.lastname: Antonaci
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology*; D000410:Alanine Transaminase / Q000097:blood; D000469:Alkaline Phosphatase / Q000097:blood; D000747:Anemia, Hypochromic / Q000209:etiology; D001219:Aspartate Aminotransferases / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002780:Cholestasis, Intrahepatic / Q000209:etiology*; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005334:Fever / Q000209:etiology*; D006801:Humans; D007239:Infections / Q000175:diagnosis; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D011649:Pulmonary Alveolar Proteinosis / Q000209:etiology*
chemical_list: D002097:C-Reactive Protein; D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase