Anaplastic myeloma in systemic lupus erythematosus.

Butler, R. Christopher; Thomas, S.; Thompson, James; Keat, Andrew

doi:10.1136/ard.43.4.653

Cited by 26 publications

(13 citation statements)

References 12 publications

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“…Foucar et al [2] reported two cases of anaplastic myeloma with poorly differentiated cells extensively involving intra-abdominal and retroperitoneal sites with a fatal clinical course. Similar observations of a predisposition to involve extramedullary sites and a poor prognosis have been reported by many other authors [1,3,4]. However no such evidence of any extramedullary involvement was present in our case.…”

Section: Dear Editorsupporting

confidence: 92%

Anaplastic myeloma: a morphologic diagnostic dilemma

Rao

Kar

Pati

2008

Indian J Hematol Blood Transfus

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Section: Dear Editorsupporting

confidence: 92%

Anaplastic myeloma: a morphologic diagnostic dilemma

Rao

Kar

Pati

2008

Indian J Hematol Blood Transfus

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“…The development of neoplasia has been reported to vary from 2.6 to 11.4%, although fewer than 1% of deaths were a consequence of malignancy [1][2][3]. The cited malignancies that are frequent ly found are lymphoma [4,5], myeloma [6,7] and leukemia [8]. O f the solid tumors, uterine [7] and breast tumors [5,7,9] are the types more commonly reported.…”

mentioning

confidence: 99%

Systemic Lupus Erythematosus and Thymoma – A Double-Edged Sword

Zandman‐Goddard

Lorber²,

Shoenfeld³

1995

Int Arch Allergy Immunol

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The coexistence of systemic lupus erythematosus (SLE) and thymoma is rare. We describe 2 female patients with this combination. A 48-year-old woman presented with dyspnea due to a left pleural effusion. Her past history revealed over the previous 3 years the development of anemia, thrombocytopenia, alopecia, pericardial effusion and proteinuria. Four months prior to this hospitalization, the patient was first admitted due to purpura. At that time, laboratory tests revealed an elevated sedimentation rate, elevated titers of ANA and anti-DNA. Chest X-ray demonstrated a widened mediastinum, and upon operation an encapsulated thymoma was excised. Four months following the thymectomy, the patient is unresponsive despite high dose steroid therapy. Another patient, a 30-year-old woman, presented with SLE (cutaneous, arthritis, anemia, positive ANA and high titers of anti-DNA) and thymoma simultaneously. Six years after thymectomy the patient is in SLE remission. Thymectomy in mice prone to autoimmunity (NZB/W mice) has been shown to accelerate the autoimmune manifestations. Conversely, the opposite effect is seen in MRL/1pr mice. The immunological effect of adult thymectomy on the course of human SLE remains to be established, on a larger series of patients. It seems that the heterogenicity of human patients is exemplified by the contrasting effects of thymectomy for thymoma in SLE patients.

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“…Our patient developed an IgA lambda-type MM 7 years after suffering late-onset SLE, which has only rarely been described [7][8][9][10][11][12][13][14][15]. SLE is characterized by a polyclonal activation of B cells which seldom result in lymphoma [2,[19][20][21], with the susceptibility to MM possibly arising due to a chronic immune stimulation, immunosuppressive therapy or to an increased vulnerability of these patients to Epstein-Barr virus infections [4,6].…”

Section: Discussionmentioning

confidence: 95%

“…[1][2][3][4][5][6]. Although the coexistence of multiple myeloma (MM) and SLE has been described in humans, it remains extremely rare [7][8][9][10][11][12][13][14][15]. We describe a patient who developed MM seven years after having developed late-onset SLE.…”

Section: Introductionmentioning

confidence: 99%

Systemic lupus Erythematosus and IgA multiple myeloma: a rare association?

Bila¹,

Suvajdžić²,

Elezović³

et al. 2007

Med Oncol

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The coexistence of systemic lupus Erythematosus (SLE) and multiple myeloma (MM) is uncommon and the pathogenetic mechanisms underlying this association remain unclear. We report the case of a woman who was diagnosed with SLE in 1993 aged 57, then developing IgA lambda type MM in the IIB clinical stage 7 years later. The SLE was treated successfully with methylprednisolone and chloroquine, and low dose maintenance steroid was continued with bisphosphonate protection until December 1994 when she suffered multiple vertebral fractures. She continued to receive 4 mg alternate day methylprednisolone and calcitonin until she decided to discontinue her own treatment 2 years later. In 2000, while still in stable SLE remission, she was diagnosed with MM. Protein electrophoresis revealed the IgA lambda paraprotein (40.5 g/l) and she had a Bence Jones (BJ) proteinuria of the lambda light chain type. Bone marrow trephine biopsy revealed a massive patchy infiltrate of abnormal plasmocytes (70%), while an extensive x-ray skeletal survey did not show any new fractures or osteolysis. The patient was treated according to the VMCP protocol without attaining a plateau phase. There was a similar poor clinical response to second and third line treatments (VAD, Thalidomide, Melphalan, and high dose dexamethasone). After 4 years of refractory disease the patient died from severe bilateral pneumonia. This case is discussed with reference to the literature.

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Anaplastic myeloma in systemic lupus erythematosus.

Cited by 26 publications

References 12 publications

Anaplastic myeloma: a morphologic diagnostic dilemma

Anaplastic myeloma: a morphologic diagnostic dilemma

Systemic Lupus Erythematosus and Thymoma – A Double-Edged Sword

Systemic lupus Erythematosus and IgA multiple myeloma: a rare association?

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