Multiple myeloma history and symptoms: Difference between revisions
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==History and Symptoms== | ==History and Symptoms== | ||
Relevant history includes: | Relevant history includes: | ||
*Review of past medical history for other [[plasma cell]] diseases, hematologic malignancies, underlying renal disease, and | *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 family history for members with positive history of hematologic malignancies | ||
*Review of occupational history related to farming, oil industry, or Agent Orange exposure | *Review of occupational history related to farming, oil industry, or Agent Orange exposure | ||
History includes character, location, onset, and duration of 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> | History includes character, location, onset, and duration of pain (typically 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 | ::*Usually involves the spine and ribs (axial skeleton), and worsens with activity | ||
::*Persistent localized pain may indicate a pathological [[bone fracture]] | ::*Persistent localized pain may indicate a pathological [[bone fracture]] | ||
::*Inability to carry out routine tasks due to limitation by pain | |||
:*Neurological symptoms | :*Neurological symptoms | ||
::*[[Numbness]] | ::*[[Numbness]] due to plasma cell infiltration of nerves or anti-neuronal glycoprotein antibodies | ||
::*[[Muscle weakness]] | ::*[[Muscle weakness]] | ||
::*[[Confusion]] | ::*[[Confusion]] | ||
| Line 28: | Line 29: | ||
::*Visual changes | ::*Visual changes | ||
:*[[Hypercalcemia]] related symptoms | :*[[Hypercalcemia]] related symptoms | ||
::*[[ | ::*[[Polyuria]] | ||
::*[[Polydipsia]] | ::*[[Polydipsia]] | ||
::*[[Constipation]] | ::*[[Constipation]] | ||
::*Loss of appetite | ::*Loss of appetite | ||
::*[[Nausea]] and vomiting | ::*[[Nausea]] and vomiting | ||
::*Lethargy | ::*Lethargy due to anemia | ||
:*Bone marrow failure-related symptoms | :*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]] | ::*Easy bruising, nosebleeds, bleeding gums due to [[thrombocytopenia]] | ||
::*Fatigue, weakness, shortness of breath, dizziness and paleness due to [[anemia]] | ::*Fatigue, weakness, shortness of breath, dizziness and paleness due to [[anemia]] | ||
::*Recurrent infections due to [[leukopenia] | ::*Recurrent infections due to [[leukopenia] | ||
:*Lower limb [[edema]] due to renal involvement | :*Lower limb [[edema]] due to renal involvement | ||
:*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 | |||
==References== | ==References== | ||
Revision as of 22:13, 19 August 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2] Shyam Patel [3]
Overview
The most common symptoms of multiple myeloma include bone pain, pallor, and fatigue.[1][2][3] However, the presenting symptoms of multiple myeloma may vary greatly due to involvement of many organ systems. The common symptoms of multiple myeloma can be remembered by the mnemonic CRAB - C = Calcium (elevated), R = Renal failure, A = Anemia, B = Bone lesions.[4][2][3]
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][5][6][7]
-
- 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
- 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
- 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
References
- ↑ 1.0 1.1 Multiple myeloma. Wikipedia (2015) https://en.wikipedia.org/wiki/Multiple_myeloma#Signs_and_symptoms Accessed on September, 20th 2015
- ↑ 2.0 2.1 2.2 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
- ↑ 3.0 3.1 3.2 Multiple myeloma. Cancer. gov(2015) http://www.cancer.gov/types/myeloma Accessed on September, 20th 2015
- ↑ International Myeloma Working Group. Criteria for the classification of monoclonal gammopathies, multiple myeloma and related disorders: a report of the International Myeloma Working Group. Br J Haematol 2003;121:749-57. PMID 12780789.
- ↑ 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.