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{{Multiple myeloma}} | {{Multiple myeloma}} | ||
{{CMG}} | {{CMG}} {{AE}} {{HMHJ}}; {{HL}}; {{shyam}} | ||
==Overview== | ==Overview== | ||
The history and symptoms of [[multiple myeloma]] are based on the underlying effect of excess [[plasma cells]] on various [[Organ (anatomy)|organ]] systems. Pain is usually a symptom of newly diagnosed [[multiple myeloma]]. Broad categories of [[Symptom|symptoms]] include bone-related [[Symptom|symptoms]], [[neurological]] [[Symptom|symptoms]], [[hypercalcemia]]-related [[symptoms]], [[bone marrow failure]]-related [[symptoms]], and [[thrombosis]]-related [[Symptom|symptoms]]. Although all of these [[symptoms]] are possible, the presentation of [[multiple myeloma]] varies from [[patient]] to [[patient]]. | |||
==History and Symptoms== | ==History and Symptoms== | ||
Relevant history includes: | |||
*Review of past medical history for other [[plasma cell]] diseases, [[hematologic]] [[malignancies]], underlying [[Kidney|renal]] [[disease]], and underlying [[bone]] [[disease]] | |||
*Review of [[family]] history for members with positive history of [[hematologic]] [[malignancies]] | |||
*Review of occupational history related to farming, oil industry, or [[Agent Orange]] exposure | |||
History includes character, location, onset, and duration of [[pain]] (typically [[Bone pain|bony pain]]). Symptoms of [[multiple myeloma]] include:<ref name="wiki">Multiple myeloma. Wikipedia (2015) https://en.wikipedia.org/wiki/Multiple_myeloma#Signs_and_symptoms Accessed on September, 20th 2015</ref><ref name="canada">Multiple myeloma. Canadian Cancer Society (2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/signs-and-symptoms/?region=mb Accessed on September 20th 2015</ref><ref name="gov">Multiple myeloma. Cancer. gov(2015) http://www.cancer.gov/types/myeloma Accessed on September, 20th 2015</ref><ref name="pmid24614435">{{cite journal |vauthors=Reisenbuckler C |title=Multiple myeloma and diagnostic imaging |journal=Radiol Technol |volume=85 |issue=4 |pages=391–410; quiz 411–3 |date=2014 |pmid=24614435 |doi= |url=}}</ref><ref name="pmid26294217">{{cite journal |vauthors=Sergentanis TN, Zagouri F, Tsilimidos G, Tsagianni A, Tseliou M, Dimopoulos MA, Psaltopoulou T |title=Risk Factors for Multiple Myeloma: A Systematic Review of Meta-Analyses |journal=Clin Lymphoma Myeloma Leuk |volume=15 |issue=10 |pages=563–77.e1–3 |date=October 2015 |pmid=26294217 |doi=10.1016/j.clml.2015.06.003 |url=}}</ref><ref name="pmid24130968">{{cite journal |vauthors=Eslick R, Talaulikar D |title=Multiple myeloma: from diagnosis to treatment |journal=Aust Fam Physician |volume=42 |issue=10 |pages=684–8 |date=October 2013 |pmid=24130968 |doi= |url=}}</ref> | |||
:*[[Bone pain]] | :*[[Bone pain]] | ||
:*[[ | ::*Usually involves the [[spine]] and [[ribs]] ([[axial skeleton]]), and worsens with activity | ||
:*[[Numbness]] | ::*Persistent localized [[pain]] may indicate a pathological [[bone fracture]] | ||
:*[[Confusion]] | ::*Inability to carry out routine tasks due to limitation by [[pain]] | ||
:*[[Dizziness]] | |||
:*[[ | :*Neurological symptoms | ||
::*[[Numbness]] due to [[plasma cell]] infiltration of [[nerves]] or anti-neuronal glycoprotein antibodies | |||
::*[[Muscle weakness]] | |||
::*[[Confusion]] | |||
::*[[Dizziness]] | |||
::*[[Headache]] | |||
::*[[Paralysis]] | |||
::*[[Visual]] changes | |||
:*[[Hypercalcemia]]-related symptoms | |||
::*[[Polyuria]] | |||
::*[[Polydipsia]] | |||
::*[[Constipation]] | |||
::*Loss of appetite | |||
::*[[Nausea and vomiting]] | |||
::*[[Lethargy]] due to [[anemia]] | |||
:*[[Bone marrow]] failure-related [[symptoms]]: This is due to crowding out of normal [[bone marrow]] precursors by [[malignant]] [[plasma cells]]. | |||
::*Easy [[bruising]], nosebleeds, bleeding [[gums]] due to [[thrombocytopenia]] | |||
::*[[Fatigue]], weakness, shortness of breath, [[dizziness]] and paleness due to [[anemia]] | |||
::*Recurrent [[infections]] due to [[leukopenia]] | |||
:*Lower [[limb]] [[edema]] due to [[renal]] involvement | |||
:*[[Thrombosis|Thrombotic]] symptoms: [[Thrombosis]] is more common in [[multiple myeloma]] due to [[cancer]]-associated [[thrombosis]] and due to [[lenalidomide]], which increases [[Thrombosis|thrombotic]] risk. | |||
::*Shortness of breath due to [[pulmonary embolism]] | |||
::*Lower [[Limb|extremity]] [[edema]] due to [[deep vein thrombosis]] | |||
::*Abdominal pain due to mesenteric venous thrombosis | |||
::*[[Transient ischemic attack]] | |||
::*[[Retinal]] [[hemorrhage]] | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category: | [[Category:Medicine]] | ||
[[Category:Hematology]] | [[Category:Hematology]] | ||
[[Category: | [[Category:Neurology]] | ||
[[Category:Neurosurgery]] | |||
[[Category:Oncology]] | [[Category:Oncology]] | ||
[[Category:Up-To-Date]] | |||
[[Category:Surgery]] | |||
Latest revision as of 22:47, 29 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Hannan Javed, M.D.[2]; Haytham Allaham, M.D. [3]; Shyam Patel [4]
Overview
The history and symptoms of multiple myeloma are based on the underlying effect of excess plasma cells on various organ systems. Pain is usually a symptom of newly diagnosed multiple myeloma. Broad categories of symptoms include bone-related symptoms, neurological symptoms, hypercalcemia-related symptoms, bone marrow failure-related symptoms, and thrombosis-related symptoms. Although all of these symptoms are possible, the presentation of multiple myeloma varies from patient to patient.
History and Symptoms
Relevant history includes:
- Review of past medical history for other plasma cell diseases, hematologic malignancies, underlying renal disease, and underlying bone disease
- Review of family history for members with positive history of hematologic malignancies
- Review of occupational history related to farming, oil industry, or Agent Orange exposure
History includes character, location, onset, and duration of pain (typically bony pain). Symptoms of multiple myeloma include:[1][2][3][4][5][6]
-
- Usually involves the spine and ribs (axial skeleton), and worsens with activity
- Persistent localized pain may indicate a pathological bone fracture
- Inability to carry out routine tasks due to limitation by pain
- Neurological symptoms
- Numbness due to plasma cell infiltration of nerves or anti-neuronal glycoprotein antibodies
- Muscle weakness
- Confusion
- Dizziness
- Headache
- Paralysis
- Visual changes
- Hypercalcemia-related symptoms
- Polyuria
- Polydipsia
- Constipation
- Loss of appetite
- Nausea and vomiting
- Lethargy due to anemia
- Bone marrow failure-related symptoms: This is due to crowding out of normal bone marrow precursors by malignant plasma cells.
- Easy bruising, nosebleeds, bleeding gums due to thrombocytopenia
- Fatigue, weakness, shortness of breath, dizziness and paleness due to anemia
- Recurrent infections due to leukopenia
- Thrombotic symptoms: Thrombosis is more common in multiple myeloma due to cancer-associated thrombosis and due to lenalidomide, which increases thrombotic risk.
- Shortness of breath due to pulmonary embolism
- Lower extremity edema due to deep vein thrombosis
- Abdominal pain due to mesenteric venous thrombosis
- Transient ischemic attack
- Retinal hemorrhage
References
- ↑ Multiple myeloma. Wikipedia (2015) https://en.wikipedia.org/wiki/Multiple_myeloma#Signs_and_symptoms Accessed on September, 20th 2015
- ↑ Multiple myeloma. Canadian Cancer Society (2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/signs-and-symptoms/?region=mb Accessed on September 20th 2015
- ↑ Multiple myeloma. Cancer. gov(2015) http://www.cancer.gov/types/myeloma Accessed on September, 20th 2015
- ↑ Reisenbuckler C (2014). "Multiple myeloma and diagnostic imaging". Radiol Technol. 85 (4): 391–410, quiz 411–3. PMID 24614435.
- ↑ Sergentanis TN, Zagouri F, Tsilimidos G, Tsagianni A, Tseliou M, Dimopoulos MA, Psaltopoulou T (October 2015). "Risk Factors for Multiple Myeloma: A Systematic Review of Meta-Analyses". Clin Lymphoma Myeloma Leuk. 15 (10): 563–77.e1–3. doi:10.1016/j.clml.2015.06.003. PMID 26294217.
- ↑ Eslick R, Talaulikar D (October 2013). "Multiple myeloma: from diagnosis to treatment". Aust Fam Physician. 42 (10): 684–8. PMID 24130968.