PMC:7224584 / 2412-4709
Annnotations
{"target":"http://pubannotation.org/docs/sourcedb/PMC/sourceid/7224584","sourcedb":"PMC","sourceid":"7224584","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7224584","text":"Multiple myeloma (MM) is a debilitating malignancy that is part of a spectrum of diseases ranging from monoclonal gammopathy of unknown significance (MGUS) to plasma cell leukemia. First described in 1848, MM is characterized by a proliferation of malignant plasma cells and a subsequent overabundance of monoclonal paraprotein (M protein). MM accounts for 1% of all cancers and is the second most common hematologic malignancy after lymphoma [1]. The estimated worldwide five-year prevalence is approximately 230,000 patients. In the Western world, the age-standardized incidence has been reported to be approximately five cases per 100,000. The median age at diagnosis is approximately 66-70 years, with 37% of patients being younger than 65. MM is extremely rare in those less than 30 years of age with a reported frequency of 0.02% to 0.3% and appears to occur slightly more frequently in men. In general, MM is not considered to be a genetic disease, however, familial cases, albeit rare, do exist. Interestingly, it was observed that relatives of patients with MGUS as compared to normal controls had a higher relative risk of developing MGUS (2.8 fold), MM (2.9 fold), Waldenström macroglobulinemia (4.0 fold), and chronic lymphocytic leukemia [2]. This disease commonly presents with hypercalcemia, renal failure, anemia, and bone lesions (the CRAB features), which are used in diagnostic evaluation for MM. This set of symptoms consists of hypercalcemia and bone pain secondary to lytic bone lesions and increased osteoclastic activity. Anemia is found in about 73% of MM patients at presentation. Renal failure is the focus of this case report and occurs most commonly due to pathologic light chain deposition in the kidneys. Elevated creatinine is found in about half of the MM patients at presentation. While renal impairment is a frequent presenting symptom, it rarely is the singular presenting symptom of MM [3]. To determine the cause of kidney failure, we often need to perform a kidney biopsy in order to take a closer look at the glomeruli and tubules. When a patient has cast MM, it is possible to see the tubules full of proteins that block the inside of the tubule. The glomeruli of the kidney are typically not affected in the cast nephropathy and usually appear normal [4].","tracks":[{"project":"2_test","denotations":[{"id":"32419992-28318212-23905628","span":{"begin":1252,"end":1253},"obj":"28318212"},{"id":"32419992-22417785-23905629","span":{"begin":2294,"end":2295},"obj":"22417785"}],"attributes":[{"subj":"32419992-28318212-23905628","pred":"source","obj":"2_test"},{"subj":"32419992-22417785-23905629","pred":"source","obj":"2_test"}]}],"config":{"attribute types":[{"pred":"source","value type":"selection","values":[{"id":"2_test","color":"#beec93","default":true}]}]}}