Renal failure in multiple myeloma: pathogenesis and prognostic implications

Article Abstract:

Multiple myeloma is a neoplastic disease in which bone and bone marrow are infiltrated with multiple tumor masses. One of the major complications of multiple myeloma is the development of acute or chronic renal (kidney) failure. A clue to the diagnosis is the development of azotemia, the presence of nitrogenous substances, primarily urea, in the blood. The medical records of 494 patients with previously untreated myeloma were analyzed to determine the frequency, pathogenesis, and prognosis of renal failure. There is a relationship between the extent of the myeloma and the size of the tumor masses. Acute or chronic renal failure was present in 89 patients. Thus, 18 percent of patients had renal insufficiency with an increasing frequency and severity that was proportionate to the extent of the myeloma. Excess calcium in the blood or urine in the blood (Bence Jones proteinuria) was the explanation for kidney failure in 97 percent of patients. Many patients with multiple myeloma had modest degrees of renal failure that improved with medical treatment. Improvement of renal disease was usually rapid and almost always occurred within four months of beginning therapy. Kidney biopsies are recommended for patients with moderate and irreversible degrees of azotemia that has no obvious explanation. Early diagnosis is essential so that prompt treatment can be instituted for those patients with underlying myeloma. Rapid and effective treatment will lead to normalization of kidney function and with control of the myeloma, can lead to long-term survival. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Acute renal failure, Acute kidney failure, Azotemia

---

Treatment of renal failure associated with multiple myeloma

Article Abstract:

Multiple myeloma, a malignant disease, is characterized by the infiltration, or invasion, of bone and bone marrow by myeloma cells, which form numerous tumor masses. This cancer is associated with the development of anemia, an abnormal decrease in erythrocytes or red blood cells; kidney lesions; and high levels of the protein globulin in the blood. Kidney failure is a frequent and severe complication of multiple myeloma. The effectiveness of using plasmapheresis, a method of enriching the red cell content of the blood, to prevent irreversible kidney failure in patients with multiple myeloma was assessed. Ten patients with multiple myeloma received dialysis treatment, the artificial filtration of the blood, and chemotherapy or anticancer agents. Eleven patients received diuresis, chemotherapy, and plasmapheresis. Plasmapheresis and chemotherapy decreased the levels of blood myeloma proteins more rapidly than chemotherapy alone. Only three of five patients with oliguria, or decreased urine production, who were treated by plasmapheresis, recovered. Among 16 patients with polyuria, or excessive urine formation, five patients receiving chemotherapy alone and seven patients treated with plasmapheresis and chemotherapy showed improved kidney function. These results indicate that the degree of kidney failure was determined by the extent of myeloma cast formation, or the deposition of myeloma material in the kidney. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Evaluation, Plasmapheresis

---

Disseminated echovirus infection in a patient with multiple myeloma and a functional defect in complement: treatment with intravenous immunoglobulin

Article Abstract:

A male patient with multiple myeloma, a condition in which bone and bone marrow are infiltrated by cancerous blood-forming cells, developed fever, confusion and progressive muscle weakness that resulted in paralysis. Several specimens of body fluids and muscle tissue revealed the same enterovirus group of viruses that infect the gastrointestinal tract; changes were consistent with viral myositis. Evaluation of the patient's immunoglobulin and disease-fighting blood cells revealed a decrease in specific types of cells. Intravenous therapy with immunoglobulin led to the patient's clinical recovery. This is the first reported case of enterovirus infecting the central nervous system in an adult with multiple myeloma and who also had abnormalities in his ability to fight disease. The findings suggest the usefulness of immunotherapy for this illness.

Case studies, Immunotherapy, Encephalitis, Enterovirus diseases, Enterovirus infections

Similar abstracts:

• Abstracts: Pemphigoid: Clinical, Histologic, Immunopathologic, and Therapeutic Considerations. Interobserver Reproducibility of Cervical Cytologic and Histologic Interpretations: Realistic Estimates From the ASCUS-LSIL Triage Study
• Abstracts: Mature teratoma of the retroperitoneum: radiologic, pathologic, and clinical correlation. Pancreatic transplants: CT with clinical and pathologic correlation
• Abstracts: Endoscopic US in the staging of esophageal and gastric cancer. Small, superficial esophageal carcinoma treated with high-dose-rate intracavitary irradiation only
• Abstracts: Stage I and II breast carcinoma: treatment with limited surgery and radiation therapy versus mastectomy. Cervical carcinoma: treatment results and complications of extended-field irradiation
• Abstracts: Growth hormone and pulmonary disease: metabolic effects in patients receiving parenteral nutrition. Oerskovia infection caused by contaminated home parenteral nutrition solution

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.