Liver involvement in multiple myeloma: a hospital based retrospective study.
OBJECTIVE
This study was to assess liver involvement in multiple myeloma with the aid of liver function tests.


METHODS
A hospital based retrospective study was undertaken using data retrieved of multiple myeloma from the register maintained in the Department of Biochemistry of the Manipal Teaching Hospital, Pokhara, Nepal between 1st January, 2007 and 28th February, 2012. We collected biomarkers of liver profiles including bilirubin (Total, Direct and Indirect), total protein, albumin, AG ratio, SGOT, SGPT, ALP, γGT, LDH, ferritin, renal profile and hematological profile. Descriptive statistics and testing of hypothesis were used for the analysis using EPI INFO and SPSS 16 software.


RESULTS
Out of 37 cases of multiple myeloma, serum level of AST, ALT, ALP, γGT and LDH were increased above the cut-off point in 22 (59.5%), 24 (64.86%), 13 (35.13%), 9 (24.3%) and 11 (29.7%) respectively. The mean values of AST (65.5±28.18 U/L), ALT (68.37±29.74 U/L), ALP (328.0±148.4 U/L), γGT (44.5±29.6 U/L) and LDH (361.7±116.5 U/L), total protein (9.79±1.03 gm/ dl) were significantly increased when compared with controls. In contrast, albumin (3.68±0.43 gm/dl) and the AG ratio (0.62±0.15) were significantly decreased. Similarly, anemia, hyperuricemia, azotemia, hypercalcaemia and Bence Jones proteinuria were found in 30 (78.9%), 27 (71.1%), 19 (51.5%), 15 (39.5%) and 16 (42.1%) respectively, in cases of multiple myeloma.


CONCLUSIONS
While clinical manifestation of liver disease among the multiple myeloma was not common, abnormalities in liver function were characteristic.
Department of Biochemistry, Manipal College of Medical Sciences (MCOMS), Manipal Teaching Hospital (MTH), Pokhara, Nepal. bibekclb@yahoo.com
Bibek
B
Poudel
Ankush
A
Mittal
Rojeet
R
Shrestha
Mohammad Shamim
MS
Farooqui
Naval Kishor
NK
Yadav
Pramod Shanker
PS
Shukla
D000328:Adult; D000410:Alanine Transaminase / Q000378:metabolism; D000469:Alkaline Phosphatase / Q000378:metabolism; D001219:Aspartate Aminotransferases / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism*; D005260:Female; D005293:Ferritins / Q000378:metabolism; D005500:Follow-Up Studies; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D008107:Liver Diseases / Q000175:diagnosis* / Q000209:etiology* / Q000378:metabolism; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000378:metabolism; D011379:Prognosis; D012189:Retrospective Studies; D005723:gamma-Glutamyltransferase / Q000378:metabolism
D015415:Biomarkers; D005293:Ferritins; D007770:L-Lactate Dehydrogenase; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase