title: [IgM-lambda multiple myeloma presenting with systemic amyloidosis].
abstract: 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.
authors.affiliation: Depertment of Medicine and Clinical Science, Gunma University Graduate School of Medicine.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Higeta
authors.forename: Akihiko
authors.initials: A
authors.lastname: Yokohama
authors.forename: Youhei
authors.initials: Y
authors.lastname: Osaki
authors.forename: Kenichi
authors.initials: K
authors.lastname: Tahara
authors.forename: Momoko
authors.initials: M
authors.lastname: Mawatari
authors.forename: Tomomi
authors.initials: T
authors.lastname: Sekigami
authors.forename: Hiromi
authors.initials: H
authors.lastname: Koiso
authors.forename: Takayuki
authors.initials: T
authors.lastname: Saito
authors.forename: Hideki
authors.initials: H
authors.lastname: Uchiumi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Handa
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Karasawa
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Murakami
authors.forename: Jyunko
authors.initials: J
authors.lastname: Hirato
authors.forename: Norifumi
authors.initials: N
authors.lastname: Tsukamoto
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Nojima
mesh_terms: 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
chemical_list: D001897:Boronic Acids; D007075:Immunoglobulin M; D011719:Pyrazines; D014750:Vincristine; D000069286:Bortezomib; D003907:Dexamethasone; D004317:Doxorubicin