Some facts about this disease:
- Malignant disorder of plasma cells
- Peak incidence between 60-70 years
- Rare under the age of 30
- Males are affected more than females.
-The tissues are infiltrated by proliferating cells.
-One type of abnormal immunoglobulins (paraprotein) usually IgG or IgA.
-This paraprotein may cause auto-immune manifestations.
-The paraprotein may coat the platelets and coagulation factors.
-Production of incomplete immunoglobulins (light chain only) by plas. cells which are excreted in urine (Bence-Jones protein).
-Diminished production of normal immunoglobulins increases infections.
- Bone aches and pathological fractures
- Multiple osteolytic lesions in the skull and osteoclast stimulation
- Compression of spinal cord by vertebral lesion
- Infiltration of roots, nerves and muscles by plasma cells.
iii- Renal Failure: due to:
- Bence-Jones proteins: precipitated in kidneys
- Nephrocalcinosis: caused by hypercalcaemia
- Hyperuricaemia: due to destruction of plasma cells
- Amyloidosis of kidneys
- Pyelonephritis: due to susceptibility to infections
iv- Anemia: due to:
- BM (bone marrow) replacement by plasma cells
- BM inhibition by chemotherapy and radiotherapy
- Haemolysis caused by paraprotein
- Renal impairment
v- Bleeding Tendency due to:
- Coating of coagulation factors by paraprotein
- Coating of platelets by paraprotein
- Raynoud’s phenomenon due to cold antibodies
- Hyperviscosity syndrome
- Repeated infections
1- Blood picture:
- Increased ESR
2- BM Examination:
Full of plasma cells
- Increased calcium in blood
- Increased uric acid in blood
- Alkaline phosphatase: normal
4- Immuno electrophoresis:
Shows marked increase in one type of immunoglobulins
- Bence-Jones proteins
- Urine electrophoresis: for paraprotein and light chains
- Kidney function tests: may be impaired
Multiple osteolytic lesions in bones especially in vertebrae, skull and pelvis.
Melphalan or cyclophosphamide.
To control tumour masses.
e.g. infection, renal failure and pain.