Atypical Presentation of Multiple Myeloma: From Heart Failure to Multiple Myeloma

Multiple myeloma (MM) is a hematological malignancy commonly associated with bone pain, hypercalcemia, and renal failure. However, its presentation can occasionally mimic other medical conditions, which may delay diagnosis. This case report describes a patient who was initially diagnosed and treate...

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Main Authors: Ainur Elliana Sohaimi, Nur Syazwani Jamhuri, Ismail Ibrahim, Hotimah Masdan Salim
Format: Article
Language:English
Published: Universitas Nahdlatul Ulama Surabaya 2024-10-01
Series:Medical and Health Science Journal
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Online Access:https://journal2.unusa.ac.id/index.php/MHSJ/article/view/6068
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author Ainur Elliana Sohaimi
Nur Syazwani Jamhuri
Ismail Ibrahim
Hotimah Masdan Salim
author_facet Ainur Elliana Sohaimi
Nur Syazwani Jamhuri
Ismail Ibrahim
Hotimah Masdan Salim
author_sort Ainur Elliana Sohaimi
collection DOAJ
description Multiple myeloma (MM) is a hematological malignancy commonly associated with bone pain, hypercalcemia, and renal failure. However, its presentation can occasionally mimic other medical conditions, which may delay diagnosis. This case report describes a patient who was initially diagnosed and treated for heart failure but was later found to have MM, highlighting the importance of considering MM in the differential diagnosis of heart failure. A 56-year-old lady presented with recurrent episodes of shortness of breath, orthopnea, paroxysmal nocturnal dypsnea and bilateral lower limb swelling which she had been treated for decompensated heart failure with optimal therapy. She denied any family history of cardiovascular disease personal history of underlying medical condition and was a nonsmoker. This patient was diagnosed with multiple myeloma and probability of concomitant cardiac amyloidosis and commenced on bortezomib, thalidomide and dexamethasone (VTD) regime and standard optimal therapy of heart failure but her condition deteriorated. After a few days of starting chemotherapy, patient demised despite all the resuscitative effort. Multiple myeloma is common hematological malignancy with its distinct clinical features of “CRAB”, however, more attention and alertness should also be exercised by clinicians as to be able to diagnose it early.
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language English
publishDate 2024-10-01
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spelling doaj-art-36be0fa905ab4bcd9944db777f2842d82025-08-20T02:11:30ZengUniversitas Nahdlatul Ulama SurabayaMedical and Health Science Journal2549-75882549-75962024-10-0180210.33086/mhsj.v8i02.6068Atypical Presentation of Multiple Myeloma: From Heart Failure to Multiple MyelomaAinur Elliana Sohaimi0Nur Syazwani Jamhuri1Ismail Ibrahim2Hotimah Masdan Salim3Department of Internal Medicine, Kulliyyah of Medicine, International Islamic University Malaysia, MalaysiaDepartment of Internal Medicine, Kulliyyah of Medicine, International Islamic University Malaysia, MalaysiaDepartment of Internal Medicine, Kulliyyah of Medicine, International Islamic University Malaysia, MalaysiaDepartment of Biochemistry and Molecular Biology, Faculty of Medicine, Universitas Nahdlatul Ulama Surabaya, Indonesia Multiple myeloma (MM) is a hematological malignancy commonly associated with bone pain, hypercalcemia, and renal failure. However, its presentation can occasionally mimic other medical conditions, which may delay diagnosis. This case report describes a patient who was initially diagnosed and treated for heart failure but was later found to have MM, highlighting the importance of considering MM in the differential diagnosis of heart failure. A 56-year-old lady presented with recurrent episodes of shortness of breath, orthopnea, paroxysmal nocturnal dypsnea and bilateral lower limb swelling which she had been treated for decompensated heart failure with optimal therapy. She denied any family history of cardiovascular disease personal history of underlying medical condition and was a nonsmoker. This patient was diagnosed with multiple myeloma and probability of concomitant cardiac amyloidosis and commenced on bortezomib, thalidomide and dexamethasone (VTD) regime and standard optimal therapy of heart failure but her condition deteriorated. After a few days of starting chemotherapy, patient demised despite all the resuscitative effort. Multiple myeloma is common hematological malignancy with its distinct clinical features of “CRAB”, however, more attention and alertness should also be exercised by clinicians as to be able to diagnose it early. https://journal2.unusa.ac.id/index.php/MHSJ/article/view/6068Multiple myelomacardiac amyloidosissystemic amyloidosisheart failureAL amyloidosis
spellingShingle Ainur Elliana Sohaimi
Nur Syazwani Jamhuri
Ismail Ibrahim
Hotimah Masdan Salim
Atypical Presentation of Multiple Myeloma: From Heart Failure to Multiple Myeloma
Medical and Health Science Journal
Multiple myeloma
cardiac amyloidosis
systemic amyloidosis
heart failure
AL amyloidosis
title Atypical Presentation of Multiple Myeloma: From Heart Failure to Multiple Myeloma
title_full Atypical Presentation of Multiple Myeloma: From Heart Failure to Multiple Myeloma
title_fullStr Atypical Presentation of Multiple Myeloma: From Heart Failure to Multiple Myeloma
title_full_unstemmed Atypical Presentation of Multiple Myeloma: From Heart Failure to Multiple Myeloma
title_short Atypical Presentation of Multiple Myeloma: From Heart Failure to Multiple Myeloma
title_sort atypical presentation of multiple myeloma from heart failure to multiple myeloma
topic Multiple myeloma
cardiac amyloidosis
systemic amyloidosis
heart failure
AL amyloidosis
url https://journal2.unusa.ac.id/index.php/MHSJ/article/view/6068
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AT nursyazwanijamhuri atypicalpresentationofmultiplemyelomafromheartfailuretomultiplemyeloma
AT ismailibrahim atypicalpresentationofmultiplemyelomafromheartfailuretomultiplemyeloma
AT hotimahmasdansalim atypicalpresentationofmultiplemyelomafromheartfailuretomultiplemyeloma