title: Stridor: unusual presentation of multiple myeloma.
abstract: We present a patient with multiple myeloma whose only presenting symptom was stridor caused by a subglottic stenosis. Biopsy suggested the presence of amyloid which prompted immunological investigations that showed hypogammaglobulinaemia and the presence of Bence Jones proteinuria at 0.93 g/24 hours. Further investigation demonstrated a 15 per cent plasma cell infiltrate into the bone marrow and a lytic lesion in the mid-shaft of the right femur. Chemotherapy and localized radiotherapy were commenced. This is a most unusual presentation of multiple myeloma and shows that immunoglobulin profiles should be properly investigated in such cases.
authors.affiliation: Department of Clinical Biochemistry, Queen Alexandra Hospital, Portsmouth, UK. david.sinclair@porthosp.nhs.uk
authors.forename: David
authors.initials: D
authors.lastname: Sinclair
authors.forename: Adel
authors.initials: A
authors.lastname: Resouly
authors.forename: Anne
authors.initials: A
authors.lastname: Spedding
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001536:Bence Jones Protein / Q000652:urine; D006801:Humans; D007829:Laryngostenosis / Q000209:etiology / Q000473:pathology; D008297:Male; D009101:Multiple Myeloma / Q000150:complications* / Q000473:pathology; D012135:Respiratory Sounds / Q000209:etiology*
chemical_list: D001536:Bence Jones Protein