Recurrent pleural effusion in myeloma.

Autor: Woo WH; Department of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia., Ithnin A; Department of Pathology, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia., Raffali MAAM; Department of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia., Abd Hamid MF; Department of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia., Abdul Wahid SF; Department of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia., Wan Jamaludin WF; Department of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia.
Jazyk: angličtina
Zdroj: Oxford medical case reports [Oxf Med Case Reports] 2022 Aug 18; Vol. 2022 (8), pp. omac091. Date of Electronic Publication: 2022 Aug 18 (Print Publication: 2022).
DOI: 10.1093/omcr/omac091
Abstrakt: Plasma cell (PC) disorders make up a spectrum of diseases which include myeloma and amyloidosis. Pleural effusion in myeloma is rare and may result from myelomatous infiltration of the pleura or heart failure in cardiac amyloidosis. Benign causes of pleural effusion include infection, hypoalbuminemia or chronic renal impairment. Myelomatous pleural effusion (MPE) is diagnosed via pleural fluid cytomorphology and flow cytometry for malignant PCs, protein electrophoresis or pleural biopsy. A 74-year-old man with immunoglobulin A myeloma developed recurrent MPE with possible secondary cardiac amyloidosis. Despite achieving partial remission in serum paraprotein, the effusion was refractory to percutaneous drainage and pleurodesis. The treatment is aimed at eradicating myeloma and relieving respiratory symptoms. Early recognition of myeloma progression into extramedullary infiltration and secondary amyloidosis is important. While chemotherapy intensification in older patients can be challenging, multidisciplinary management is essential in alleviating symptoms and in improving the quality of life.
(© The Author(s) 2022. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)
Databáze: MEDLINE
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