[Infectious pleurisy as first sign of multiple myeloma in a young 28 years old].
Multiple myeloma is a malignant proliferation of plasma cells, mainly affecting the bone marrow. It rarely occurs in young patients. The medical observation study reveals multiple myeloma discovered through a purulent pleurisy in a 28-year-old subject. This patient was admitted to the pneumology service of the Mohamed V military hospital in Rabat for a fever and dyspnea evolving into a context of poor general condition. Clinical examination found a right pleural fluid effusion syndrome. The pleural puncture reveals a germ-free exudative purulent fluid without plasma cells. The myeloma diagnosis was suspected due to the combination of an aplastic normochromic normocytic anemia at 4.5g/dL of hemoglobin, an accelerated erythrocyte sedimentation rate, hypercalcemia, renal failure and osteolytic lesions located mainly in the skull and pelvis area, oriented by electrophoresis and serum protein immunosubstraction revealing a narrow peak in monoclonal beta-2 globulin at 70.56g/L with a lambda monoclonal gammopathy with immunoglobulin G, and confirmed by the myelogram showing a 74% rate of bone marrow plasma cells. The occurrence of myeloma at a young age is rare and the purulent pleurisy without plasma cells is a rare form of presentation and represents a poor prognosis.
Service de pneumologie, hôpital militaire d'instruction Mohamed V, BP 10045, Rabat, Maroc. Electronic address: anass-ab@hotmail.fr.
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Benali
Laboratoire d'hématologie, hôpital militaire d'instruction Mohamed V, BP 10045, Rabat, Maroc.
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Kahouli
Service de pneumologie, hôpital militaire d'instruction Mohamed V, BP 10045, Rabat, Maroc.
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El Ouazzani
Service de pneumologie, hôpital militaire d'instruction Mohamed V, BP 10045, Rabat, Maroc.
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Souhi
Service de pneumologie, hôpital militaire d'instruction Mohamed V, BP 10045, Rabat, Maroc.
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Abderrahmani Rhorfi
Service de pneumologie, hôpital militaire d'instruction Mohamed V, BP 10045, Rabat, Maroc.
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Abid
Laboratoire d'hématologie, hôpital militaire d'instruction Mohamed V, BP 10045, Rabat, Maroc.
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Yahyaoui
Laboratoire d'hématologie, hôpital militaire d'instruction Mohamed V, BP 10045, Rabat, Maroc.
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Zahid
Laboratoire d'hématologie, hôpital militaire d'instruction Mohamed V, BP 10045, Rabat, Maroc.
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Messaoudi
D000328:Adult; D006801:Humans; D008297:Male; D009101:Multiple Myeloma / Q000175:diagnosis*; D016066:Pleural Effusion, Malignant / Q000209:etiology; D010998:Pleurisy / Q000209:etiology*
Immunoglobulin G; Immunoglobulines G; Jeune; Multiple myeloma; Myélome multiple; Os sphénoïde; Osteolysis; Ostéolyse; Pleurisy; Pleurésie; Sphenoid bone; Young