Peripheral neuropathy and multiple myeloma in aging: a case report

Area of Science:

• Neurology
• Oncology
• Hematology

Background:

• A 67-year-old male presented with weight loss, acral paresthesia, and plantar burning.
• Initial assessments revealed peripheral, asymmetrical, motor-sensorial polyneuropathy (PPN).
• Hematological data and bone marrow biopsy identified non-secreting multiple myeloma (MM).

Purpose of the Study:

• To investigate the potential relationship between peripheral polyneuropathy (PPN) and multiple myeloma (MM).
• To exclude other common causes of neuropathy and specific MM-associated syndromes.
• To analyze the unique clinical presentation in the context of existing literature.

Main Methods:

• Electromyography (EMG) and electroneurography (ENG) for neurological assessment.
• Hematological analysis and bone marrow biopsy for myeloma diagnosis.
• Radiological imaging and clinical evaluation to rule out specific MM-associated conditions.

Main Results:

• EMG/ENG confirmed PPN; hematology confirmed non-secreting MM.
• Other potential causes of neuropathy and specific MM-associated syndromes (osteosclerotic, Crow-Fukase, amyloid) were excluded.
• The patient exhibited osteolytic bone lesions but lacked organomegaly, diabetes, skin changes, or amyloid deposition.

Conclusions:

• The case confirms an association between peripheral polyneuropathy (PPN) and multiple myeloma (MM).
• The presentation deviates from typical MM-associated neuropathy syndromes, suggesting multiform clinical variants.
• This highlights the importance of considering PPN in MM patients and vice versa, even with atypical features.