title: [Multiple myeloma accompanying splenic amyloidosis and overwhelming pneumococcemia].
abstract: We present the case of an 84-year-old woman with multiple myeloma who developed overwhelming pneumococcemia. Significant pathologic findings of amyloidosis were confirmed in the spleen, adrenal glands, kidneys, liver and bone marrow on autopsy. In particular, the spleen was almost replaced by diffuse linear deposition of amyloid, and residual lymphoid tissue was scant. There is a well-established association between asplenia and a predisposition to fulmination, frequently with fatal bacterial infection. In this case, functional hyposplenism as a result of amyloid replacement of the spleen led to overwhelming pneumococcemia. Functional hyposplenism due to amyloidosis predisposes patients to septicemia. As bacterial infections are a common complication in patients with multiple myeloma, it is important to know whether they have accompanying splenic amyloidosis. If there are findings of hyposplenism, it may be necessary to establish strategies to prevent fatal infection. Thought needs to be given to providing detailed education, and prophylactic or stand-by antibiotics for such patients.
authors: Internal Medicine, Matsusaka Chuo Hospital.
authors: Kei
authors: K
authors: Suzuki
authors: Kazuko
authors: K
authors: Ino
authors: Minoru
authors: M
authors: Mizutani
authors: Kohshi
authors: K
authors: Ohishi
authors: Takao
authors: T
authors: Sekine
authors: Naoyuki
authors: N
authors: Katayama
mesh_terms: D000369:Aged, 80 and over; D000686:Amyloidosis / Q000150:complications*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D009101:Multiple Myeloma / Q000150:complications*; D009894:Opportunistic Infections; D011008:Pneumococcal Infections / Q000150:complications*; D018805:Sepsis / Q000150:complications*; D013158:Splenic Diseases / Q000150:complications*