Multiple myeloma in primary biliary cirrhosis

A patient who had primary biliary cirrhosis and, simultaneously, multiple myeloma (IgG, lambda) is reported. In chronic liver diseases, polyclonal hypergammaglobulinaemia is common, monoclonal gammopathies have also been found in rare instances, being attributed to chronic antigenic stimulation of the reticuloendothelial system by antigens from the intestinal flora. The mechanisms (as chronic antigenic stimulation, immunologic disturbances and granulomata formation) which apply to explain the development of monoclonal gammopathies in other conditions are also found in primary biliary cirrhosis. It is postulated that, in this disease, the development of multiple myeloma could be not merely coincidental but also the result of chronic stimulation of the reticuloendothelial system.