title: Hepatic failure caused by plasma cell infiltration in multiple myeloma.
abstract: Although plasma cell infiltration is not rare in autopsy of patients with multiple myeloma (MM), it is very rarely detected in living patients. This is because MM rarely causes significant liver dysfunction that requires further evaluation. A 49-year-old man presented with acute renal failure and was diagnosed with kappa light chain MM stage IIB. Thalidomide and dexamethasone were initiated. The patient developed a continuous increase in bilirubin that led to severe cholestasis. A liver biopsy revealed plasma cell infiltration. He then rapidly progressed to liver failure and died. Treatment options are limited in MM with significant liver dysfunction. Despite new drug therapies in MM, those patients with rapidly progressive liver failure appear to have a dismal outcome.
authors.affiliation: Section of Gastroenterology, Department of Medicine, Medical College of Georgia, 1120 15th Street, Augusta, GA 30912, USA. fadirahhal@yahoo.com
authors.forename: Fadi-E
authors.initials: FE
authors.lastname: Rahhal
authors.forename: Robert-R
authors.initials: RR
authors.lastname: Schade
authors.forename: Asha
authors.initials: A
authors.lastname: Nayak
authors.forename: Teresa A
authors.initials: TA
authors.lastname: Coleman
mesh_terms: D017809:Fatal Outcome; D006801:Humans; D008099:Liver / Q000378:metabolism / Q000473:pathology; D017093:Liver Failure / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000503:physiopathology; D010950:Plasma Cells / Q000378:metabolism*