Dermatologic Signs of Multiple Myeloma  

Oleh:

Schosser, Robert Hill ; Green, W. Harris

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 365 no. 01 (Jul. 2011), page 71.
Topik: Atraumatic Ecchymoses; Periorbital; Bortezomib
Fulltext: Multiple Myeloma.pdf (74.34KB)

Ketersediaan

Perpustakaan FK Nomor Panggil: N08.K.2011.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

An 87-year-old woman presented for evaluation of progressive, nonpruritic, waxy papules and atraumatic ecchymoses in a periorbital (“raccoon eyes,” Panel A) and perioral distribution. She was otherwise asymptomatic. Examination of a biopsy specimen of a representative lesion revealed a nodular deposition of a hyalinized, amorphous material in the superficial dermis. Positive Congo red staining and apple-green birefringence under polarized light (Panel B) confirmed the presence of amyloid fibrils. Serum and urine electrophoresis with immunofixation revealed monoclonal kappa light-chain proteins. Levels of hemoglobin and serum calcium were unremarkable, as were the results of a radiographic skeletal survey. Renal function was stable, with only a mildly reduced glomerular filtration rate. Biopsy samples of bone marrow revealed that 22% of marrow cellularity consisted of plasma cells that stained predominantly for kappa light-chain proteins. A diagnosis of kappa light-chain multiple myeloma with systemic amyloidosis was made. After initial treatment with melphalan and prednisone, the patient's condition stabilized, and at 2 years of follow-up she continued treatment with bortezomib alone.

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