Obstructive Jaundice as Initial Presentation of Multiple Myeloma: Case Presentation and Literature Review
Multiple myeloma is a malignant plasma-cell disorder that primarily involves the bone marrow, but extramedullary involvement is becoming increasingly common (Bladé et al., 2012) both at initial presentation and follow-up. Most common initial presentations for multiple myeloma include generalized fat...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2015-01-01
|
| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2015/686210 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850172252141649920 |
|---|---|
| author | Yasir Khan Iyad Mansour Eric Ong Manish Shrestha |
| author_facet | Yasir Khan Iyad Mansour Eric Ong Manish Shrestha |
| author_sort | Yasir Khan |
| collection | DOAJ |
| description | Multiple myeloma is a malignant plasma-cell disorder that primarily involves the bone marrow, but extramedullary involvement is becoming increasingly common (Bladé et al., 2012) both at initial presentation and follow-up. Most common initial presentations for multiple myeloma include generalized fatigue, renal insufficiency, bone pain, and recurrent bacterial infections. We present a case of a healthy 55-year-old man that presented to the emergency department with a three-week history of anorexia and jaundice without any past medical history. Patient’s initial labs were significant for hyperbilirubinemia and elevated liver function enzymes (AST, ALT, ALP, and GGT). Additional laboratory workup was significant for mild hypercalcemia and increased protein gap. MRI and ERCP suggested primary sclerosing cholangitis but were not diagnostic. Liver biopsy illustrated plasma-cell infiltration and bone marrow biopsy diagnosed multiple myeloma with extramedullary disease. Patient was started on dexamethasone, bortezomib, and cyclophosphamide, but, despite this aggressive regimen, the patient continued to decline. We take this opportunity to present this atypical presentation of a common hematological malignancy and review the associated literature. |
| format | Article |
| id | doaj-art-cf93ff4142ed4ef9b96421f3351db148 |
| institution | OA Journals |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-cf93ff4142ed4ef9b96421f3351db1482025-08-20T02:20:07ZengWileyCase Reports in Medicine1687-96271687-96352015-01-01201510.1155/2015/686210686210Obstructive Jaundice as Initial Presentation of Multiple Myeloma: Case Presentation and Literature ReviewYasir Khan0Iyad Mansour1Eric Ong2Manish Shrestha3University of Arizona Internal Medicine Residency, 1501 N. Campbell Avenue, Tucson, AZ 85724, USAUniversity of Arizona Internal Medicine Residency, 1501 N. Campbell Avenue, Tucson, AZ 85724, USAUniversity of Arizona Internal Medicine Residency, 1501 N. Campbell Avenue, Tucson, AZ 85724, USAUniversity of Arizona Internal Medicine Residency, 1501 N. Campbell Avenue, Tucson, AZ 85724, USAMultiple myeloma is a malignant plasma-cell disorder that primarily involves the bone marrow, but extramedullary involvement is becoming increasingly common (Bladé et al., 2012) both at initial presentation and follow-up. Most common initial presentations for multiple myeloma include generalized fatigue, renal insufficiency, bone pain, and recurrent bacterial infections. We present a case of a healthy 55-year-old man that presented to the emergency department with a three-week history of anorexia and jaundice without any past medical history. Patient’s initial labs were significant for hyperbilirubinemia and elevated liver function enzymes (AST, ALT, ALP, and GGT). Additional laboratory workup was significant for mild hypercalcemia and increased protein gap. MRI and ERCP suggested primary sclerosing cholangitis but were not diagnostic. Liver biopsy illustrated plasma-cell infiltration and bone marrow biopsy diagnosed multiple myeloma with extramedullary disease. Patient was started on dexamethasone, bortezomib, and cyclophosphamide, but, despite this aggressive regimen, the patient continued to decline. We take this opportunity to present this atypical presentation of a common hematological malignancy and review the associated literature.http://dx.doi.org/10.1155/2015/686210 |
| spellingShingle | Yasir Khan Iyad Mansour Eric Ong Manish Shrestha Obstructive Jaundice as Initial Presentation of Multiple Myeloma: Case Presentation and Literature Review Case Reports in Medicine |
| title | Obstructive Jaundice as Initial Presentation of Multiple Myeloma: Case Presentation and Literature Review |
| title_full | Obstructive Jaundice as Initial Presentation of Multiple Myeloma: Case Presentation and Literature Review |
| title_fullStr | Obstructive Jaundice as Initial Presentation of Multiple Myeloma: Case Presentation and Literature Review |
| title_full_unstemmed | Obstructive Jaundice as Initial Presentation of Multiple Myeloma: Case Presentation and Literature Review |
| title_short | Obstructive Jaundice as Initial Presentation of Multiple Myeloma: Case Presentation and Literature Review |
| title_sort | obstructive jaundice as initial presentation of multiple myeloma case presentation and literature review |
| url | http://dx.doi.org/10.1155/2015/686210 |
| work_keys_str_mv | AT yasirkhan obstructivejaundiceasinitialpresentationofmultiplemyelomacasepresentationandliteraturereview AT iyadmansour obstructivejaundiceasinitialpresentationofmultiplemyelomacasepresentationandliteraturereview AT ericong obstructivejaundiceasinitialpresentationofmultiplemyelomacasepresentationandliteraturereview AT manishshrestha obstructivejaundiceasinitialpresentationofmultiplemyelomacasepresentationandliteraturereview |