A Possible Pathogenic Mechanism for Rhabdomyolysis Associated with Multiple Myeloma

Fernández-Solà, J; Cases, A; Monforte, R.; Pedro‐Botet, Juan; Estruch, R; Grau, J M; Urbano-Márquez, Á

doi:10.1159/000206001

Cited by 8 publications

(6 citation statements)

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“…In general, reports on MM associated with muscular disorders are scarce. The combination of MM and rhabdomyolysis has previously been identified in a single case (2), and polymyositis has been described in one patient 18 months following diagnosis of MM (14).…”

Section: Discussionmentioning

confidence: 96%

“…Autoantibody binding to muscle proteins, or light chain deposition in muscle tissue, was previously suggested by Fernández‐Solá et al . (2) to play a pathogenic role in rhabdomyolysis. The presence of autoantibodies to muscle proteins could also be secondary to an initial inflammatory and/or necrotic muscle lesion.…”

Section: Discussionmentioning

confidence: 99%

“…The patho‐physiological background is poorly defined, although the understanding of possible etiologic factors is increasing (1). Rhabdomyolysis is a rare complication in patients with haematological malignancies, and to our knowledge only one patient with multiple myeloma (MM) and rhabdomyolysis has been previously described (2). We here present a patient with newly diagnosed MM with an M component of the λ light chain type and generalised amyloid depositions, who developed a progressive myoglobinemia.…”

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confidence: 99%

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Antibody reactivities to skeletal muscle proteins in a patient with λ light chain secreting multiple myeloma, generalised amyloidosis and rhabdomyolysis

Sundblad

Porwit

Ostad

et al. 2001

European J of Haematology

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Rhabdomyolysis is a rare complication in haematological malignancies, and a diverse range of factors has been implicated in the etiology of the syndrome. In the present study we analysed muscle morphology and antibody reactivities to skeletal muscle proteins in a patient diagnosed with lambda (lambda) light chain-secreting multiple myeloma (MM) and amyloidosis, who developed a progressive rhabdomyolysis. The muscle tissue analysis showed focal amyloid depositions and a low degree of atrophy and inflammation. Antibody reactivities against muscle proteins of approximately 42, 51 and 66 kD, respectively, were present in the patient's serum. The antibody specificities were revealed by lambda light chain- or IgM-specific antibodies. The results indicate a possible etiologic link between antibody reactivities towards muscle proteins and muscle tissue disorder in a patient with the unique combination of rhabdomyolysis, amyloidosis and MM of the light chain type.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Antibody reactivities to skeletal muscle proteins in a patient with λ light chain secreting multiple myeloma, generalised amyloidosis and rhabdomyolysis

Sundblad

Porwit

Ostad

et al. 2001

European J of Haematology

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“…Compte tenu du contexte de myélome multiple, seulement la présence probable de myoglobine a été suspectée, avec un cas déjà rapporté par Fernández-Solá et al . [ 6 ]. Aussi des similitudes de profil électrophorétique ont été retrouvées dans l´étude menée par Rostagno A et al .…”

Section: Discussionunclassified

Analyse biochimique d´un pic insolite d´allure monoclonale en électrophorèse des protéines urinaires: à propos d´un cas

Bissan¹,

Karfo²,

Diawara³

et al. 2022

Pan Afr Med J

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L´électrophorèse des protéines urinaires est souvent nécessaire au diagnostic et au suivi de certaines pathologies urologiques ou rénales, et des hémopathies lymphoïdes. Nous rapportons le cas d´un profil atypique d´électrophorèse des protéines urinaires sur capillaire et en gel d´agarose. Il s´agit d´un pic de nature inconnue d´allure monoclonale migrant au niveau des gammaglobulines. La littérature et les dosages effectués prouvent qu´il s´agissait de la myoglobine. En effet, la myoglobine de 17,5 kDa est librement filtré par le glomérule, et normalement réabsorbé au niveau tubulaire. En cas de dépassement de sa capacité de réabsorption, sa présence entraine une protéinurie de surcharge. Cette myoglobinurie nous a permis de mettre en évidence une rhabdomyolyse aigüe chez notre patient. Ainsi, l´analyse des pics inconnus comme dans ce cas, renseigne sur des symptomatologies, mais aussi des pathologies sous-jacentes, qui peuvent avoir un intérêt clinique.

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“…Cardiac manifestations of arrhythmias, conduction disturbances, and congestive heart failure are reported in as many as 80% of cases of light chain deposition disease (LCDD) [9,12]. Though rhabdomyolysis due to light chain deposition in the cellular membrane of muscle fibers associated with Kappa light chain multiple myeloma (Kappa LCMM) was previously reported, rhabdomyolysis associated with MGRS has yet to be reported [13,14]. A literature review was conducted using PubMed, Cochrane, Scopus, and Embase, and no prior reports of rhabdomyolysis in MGRS were found.…”

Section: Introductionmentioning

confidence: 99%

Rhabdomyolysis and Acute Renal Dysfunction as Initial Manifestations of Monoclonal Gammopathy of Renal Significance

Gudapati¹,

Sultani²,

Parmar³

et al. 2023

Cureus

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Monoclonal gammopathy of renal significance (MGRS) is a rare heterogeneous group of kidney disorders that encompasses all disorders caused by deposition of monoclonal protein (M-protein) and its light or heavy chain fragments secreted by pre-malignant or non-malignant B-cell clones in patients who do not meet the diagnostic criteria for multiple myeloma (MM) or other B-cell malignancies. MGRS can manifest as glomerular diseases, tubulopathies, or vascular involvement with varying clinical presentations, making the diagnosis of MGRS challenging. In patients with high clinical suspicion based on preliminary blood and urine studies, the evaluation of MGRS begins with a renal biopsy followed by monoclonal studies and cytogenetic analysis. There is no standard treatment protocol for MGRS, and the current consensus suggests a clone-directed approach. If not identified and treated early, MGRS often results in poor outcomes and can lead to extrarenal manifestations, such as cardiogenic shock. Herein, we present a case involving a 43-yearold male with a rare presentation of rhabdomyolysis, rapidly progressing renal dysfunction, and cardiac dysfunction. A bone marrow biopsy did not meet the diagnostic criteria for MM or other B-cell malignancies, while a renal biopsy revealed Kappa light chain cast nephropathy, which led to the final diagnosis of MGRS.

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A Possible Pathogenic Mechanism for Rhabdomyolysis Associated with Multiple Myeloma

Cited by 8 publications

References 4 publications

Antibody reactivities to skeletal muscle proteins in a patient with λ light chain secreting multiple myeloma, generalised amyloidosis and rhabdomyolysis

Antibody reactivities to skeletal muscle proteins in a patient with λ light chain secreting multiple myeloma, generalised amyloidosis and rhabdomyolysis

Analyse biochimique d´un pic insolite d´allure monoclonale en électrophorèse des protéines urinaires: à propos d´un cas

Rhabdomyolysis and Acute Renal Dysfunction as Initial Manifestations of Monoclonal Gammopathy of Renal Significance

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