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🌱 來自: multiple myeloma (MM)
clinical manifestations of multiple myeloma (MM)🚧 施工中
clinical manifestations of multiple myeloma (MM)
(CRAB criteria and other less common features)
- Hyper Calcemia due to ↑ osteoclast activity
- Renal disease: multiple mechanisms include toxic effect of filtered light chains → renal failure (cast nephropathy) or type II RTA; amyloidosis or light chain deposition disease → nephrotic syndrome; hypercalcemia, urate nephropathy, type I cryoglobulinemia
- Anemia (normocytic) to bone marrow involvement; rarely, may see AIHA
- Lytic Bone lesions due to ↑ osteoclast activity → pathologic fx
- Recurrent infxns due to relative hypogammaglob. (clonal plasma cells suppress nl Ig)
- Neurologic: cord compression; POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein, skin changes) syndrome
- Hyperviscosity: usually when IgM >4 g/dL, IgG >5 g/dL, or IgA >7 g/dL
- Coagulopathy: seen in amyloid due to binding & depletion of Factor X
- AL amyloidosis (see “Amyloidosis”) (Lancet Onc 2014;15:e538)