Multiple Myeloma Mimicking a Small Vessel Vasculitis Presentation.
Mateo Mejía-Zuluaga1, Jorge Andrés Lacouture1, Maria Clara Gaviria1
1Resident of Internal Medicine, CES University, Medellín, Colombia.
Case Reports in Rheumatology
|February 27, 2020
Summary
Multiple myeloma, a cancer of plasma cells, can present unusually. This case highlights blue toe syndrome as a rare but important initial symptom, alongside acute kidney injury.
Area of Science:
- Hematology
- Oncology
- Nephrology
Background:
- Multiple myeloma is a plasma cell malignancy with diverse clinical presentations.
- Classic diagnostic criteria (CRAB: hyperCalcemia, Renal insufficiency, Anemia, Bone lesions) are not always present at diagnosis.
- Rare manifestations require careful consideration for timely diagnosis.
Observation:
- A 46-year-old female presented with acute, progressive bluish-to-black discoloration of the second toe and acute kidney injury.
- Diagnostic workup revealed Kappa light chain monoclonal gammopathy, bone marrow plasmacytosis, and multiple lytic bone lesions.
- These findings confirmed a diagnosis of multiple myeloma.
Findings:
- The patient's presentation with blue toe syndrome and acute kidney injury is an atypical manifestation of multiple myeloma.
- The presence of monoclonal gammopathy and bone lesions supports the diagnosis of multiple myeloma.
- This case underscores the importance of considering rare clinical signs in the diagnostic pathway of multiple myeloma.
Implications:
- Blue toe syndrome, though uncommon, should prompt consideration of multiple myeloma in the differential diagnosis.
- Recognizing atypical presentations can lead to earlier diagnosis and intervention for multiple myeloma.
- This case expands the understanding of the varied clinical spectrum of multiple myeloma.
More Related Videos
10:04Establishment of a Human Multiple Myeloma Xenograft Model in the Chicken to Study Tumor Growth, Invasion and Angiogenesis
Published on: May 1, 2015
13.4K
06:35An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
Published on: February 8, 2019
7.5K
Related Concept Videos
01:25Endocarditis II: Clinical Features of Infective Endocarditis
299
Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
299
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
151
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
151
01:16Vascular Spasm
3.1K
The vascular phase, also known as vasospasm, is the initial stage of hemostasis, crucial for preventing excessive bleeding when a blood vessel is injured. After a vessel is cut, nerves in the damaged area trigger pain and other sensory impulses. Simultaneously, the smooth muscles in the vessel wall contract, resulting in a vascular spasm. This contraction reduces the vessel's diameter at the injury site, slowing or stopping blood loss through the vessel wall. Vascular spasms typically last...
3.1K
01:27Myocarditis II: Clinical Features and Diagnostic Tests
195
Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
195
01:24Chronic Kidney Disease II: Clinical Manifestations
480
Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
480
01:26Nephrotic Syndrome II : Assessment and Medical Management
154
IntroductionNephrotic syndrome is a kidney disorder marked by excessive protein loss in the urine, leading to various systemic complications. This condition often results from damage to the glomeruli—the kidney's filtering units—causing proteinuria, low blood protein levels, and fluid retention. Understanding the assessment, diagnosis, and management of nephrotic syndrome is essential for effective treatment and prevention of further kidney damage.AssessmentPatient History: Document...
154