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Multiple Myeloma

 Syn. MM

Signs & Symptoms

 Central skeleton pain #criteria
Note: due to Osteolytic bone disease,note to Induced by movement ,less common at nights,usually mild to moderate in intensity
Ref: Uptodate [ Multiple Myeloma: clinical features , labaratory manifestations,and diagnosis] Harrison [ 795] Cecil [ 518]
Back pain #criteria
Note: due to Osteolytic bone disease,note to Induced by movement ,less common at nights,usually mild to moderate in intensity
Ref: Uptodate [ Multiple Myeloma: clinical features , labaratory manifestations,and diagnosis] Harrison [ 795] Cecil [ 518] Epocrates [ https://www.epocrates.com/online/diseases/179/multiple-myeloma#history-exam]
Bone pain Induced by movement #criteria
Note: due to Osteolytic bone disease,note to Induced by movement ,less common at nights,usually mild to moderate in intensity
Ref: Uptodate [ Multiple Myeloma: clinical features , labaratory manifestations,and diagnosis] Harrison [ 795] Cecil [ 518]
Bone pain #criteria
Note: due to Osteolytic bone disease,note to Induced by movement ,less common at nights,usually mild to moderate in intensity
Ref: Uptodate [ Multiple Myeloma: clinical features , labaratory manifestations,and diagnosis] Harrison [ 795] Cecil [ 518] Epocrates [ https://www.epocrates.com/online/diseases/179/multiple-myeloma#history-exam]

Physical Examination

 Localized bone tenderness
Note: due to Pathologic fracture
Ref: Harrison [ 798] Cecil [ 518]
Pallor
Note: due to Anemia
Ref: Uptodate [ Multiple Myeloma: clinical features , labaratory manifestations,and diagnosis] Cecil [ 518]
Plane xanthomas #criteria
Ref: Uptodate [ Multiple Myeloma: clinical features , labaratory manifestations,and diagnosis]

Lab / Serology

 Normocytic normochromic anemia #criteria
Note: note to Hb<10 mg/dl, due to Bone marrow infiltration of proliferating plasma cells, due to erythropoietin deficiency, due to reduced hematopoesis
Ref: Uptodate [ Multiple Myeloma: clinical features , labaratory manifestations,and diagnosis] Harrison [ 797] Cecil [ 518]
M protein component in serum
Note: due to Plasma cell production of M protein
Ref: Uptodate [ Multiple Myeloma: clinical features , labaratory manifestations,and diagnosis] Harrison [ 797] Cecil [ 518]
M protein component in urine
Note: due to Plasma cell production of M protein
Ref: Uptodate [ Multiple Myeloma: clinical features , labaratory manifestations,and diagnosis] Harrison [ 797] Cecil [ 518]

Imagin Study

 Focal lytic lesions #criteria
Note: due to Infiltration of bone marrow, due to Infiltration of bones,note to By proliferating plasma cells and activation of osteoclasts
Ref: Uptodate [ Multiple Myeloma: clinical features , labaratory manifestations,and diagnosis] Harrison [ 798] Cecil [ 518]
Punched-out lytic bone lesions #criteria
Note: due to Infiltration of bone marrow, due to Infiltration of bones,note to By proliferating plasma cells and activation of osteoclasts
Ref: Uptodate [ Multiple Myeloma: clinical features , labaratory manifestations,and diagnosis] Harrison [ 798] Cecil [ 518]
Focal bone lesions #criteria
Ref: Uptodate [ Multiple Myeloma: clinical features , labaratory manifestations,and diagnosis] Harrison [ 798]

Complication

 Punched-out lytic bone lesions #criteria
Note: due to Infiltration of bone marrow, due to Infiltration of bones,note to By proliferating plasma cells and activation of osteoclasts
Ref: Uptodate [ Multiple Myeloma: clinical features , labaratory manifestations,and diagnosis] Harrison [ 798] Cecil [ 518]
Pyelonephritis
Note: due to Hypogammaglobulinemia, due to immune deficiency,note to In 25% it is the presenting feature
Ref: Uptodate [ Multiple Myeloma: clinical features , labaratory manifestations,and diagnosis] Harrison [ 795] Cecil [ 518]
Focal lytic lesions #criteria
Note: due to Infiltration of bone marrow, due to Infiltration of bones,note to By proliferating plasma cells and activation of osteoclasts
Ref: Uptodate [ Multiple Myeloma: clinical features , labaratory manifestations,and diagnosis] Harrison [ 798] Cecil [ 518]

Risk Factors

 Male
Ref: Epocrates [ https://www.epocrates.com/online/diseases/179/multiple-myeloma#risk-factors]
Black ethnicity
Ref: Epocrates [ https://www.epocrates.com/online/diseases/179/multiple-myeloma#risk-factors]

Cause

Other