[IgM-lambda multiple myeloma presenting with systemic amyloidosis].
A 59-year-old man was referred to our hospital due to nephrotic syndrome with IgM paraproteinemia. Physical examination demonstrated marked hepatomegaly and anasarca. Serum M-protein was 0.94 g/dl and urinary analysis detected the presence of Bence Jones protein. Bone marrow plasma cell count was 11.2%. Histological examination demonstrated AL-type amyloid deposition in the liver, kidneys, bone marrow, stomach and rectum. These findings led to a diagnosis of IgM multiple myeloma with systemic amyloidosis. Although there was no apparent response to 2 courses of vincristine, doxorubicin and dexamethasone (VAD) regimen, subsequent treatment with bortezomib in combination with dexamethasone resulted in a rapid reduction in M protein to 0.49 g/dl, approximately half the pre-treatment level.
Higeta
Daisuke
D
Depertment of Medicine and Clinical Science, Gunma University Graduate School of Medicine.
Yokohama
Akihiko
A
Osaki
Youhei
Y
Tahara
Kenichi
K
Mawatari
Momoko
M
Sekigami
Tomomi
T
Koiso
Hiromi
H
Saito
Takayuki
T
Uchiumi
Hideki
H
Handa
Hiroshi
H
Karasawa
Masamitsu
M
Murakami
Hirokazu
H
Hirato
Jyunko
J
Tsukamoto
Norifumi
N
Nojima
Yoshihisa
Y
D000686:Amyloidosis / Q000175:diagnosis / Q000209:etiology*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001897:Boronic Acids / Q000008:administration & dosage; D000069286:Bortezomib; D003907:Dexamethasone / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D017809:Fatal Outcome; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D010265:Paraproteinemias / Q000097:blood / Q000150:complications; D011719:Pyrazines / Q000008:administration & dosage; D014750:Vincristine / Q000008:administration & dosage
D001897:Boronic Acids; D007075:Immunoglobulin M; D011719:Pyrazines; D014750:Vincristine; D000069286:Bortezomib; D003907:Dexamethasone; D004317:Doxorubicin