Multiple myeloma with lacrimal gland amyloidosis and sarcoidosis

Brown, G. Stephen; Shapeero, Lorraine G.; Weiss, Brendan M.; Roschewski, Mark

doi:10.1002/ajh.21695

Cited by 14 publications

(16 citation statements)

References 24 publications

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“…In the case associated with multiple myeloma, bilateral lacrimal gland masses were seen to regress following 4 cycles of lenalidomide-dexamethasone therapy followed by autologous stem cell rescue. 12 Symptoms and signs of visual disturbance or optic nerve compromise or inflammation were distinctly absent. The lacrimal gland if palpable was firm to hard and nontender.…”

Section: Discussionmentioning

confidence: 98%

“…Skin and lids involvement usually occurs in presence of systemic disease. 12 In contrast, orbital involvement, especially lacrimal gland amyloidosis, is almost always a localized disease with 2 cases reported to date with a systemic involvement. 12,13 To the best of our knowledge, 18 cases have been reported so far in the literature, 1-15 with 3 cases being just mentioned without many details.…”

Section: Discussionmentioning

confidence: 99%

“…12 In contrast, orbital involvement, especially lacrimal gland amyloidosis, is almost always a localized disease with 2 cases reported to date with a systemic involvement. 12,13 To the best of our knowledge, 18 cases have been reported so far in the literature, 1-15 with 3 cases being just mentioned without many details. 13 The clinical, radiological, and management details of 15 cases along with the present case are reflected in Table 1.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Lacrimal Gland Amyloidosis: A Clinicopathological Correlation of a Rare Disorder and Review of Literature

Batra

Ali

Mody

et al. 2013

Ocular Immunology and Inflammation

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Lacrimal Gland Amyloidosis: A Clinicopathological Correlation of a Rare Disorder and Review of Literature

Batra

Ali

Mody

et al. 2013

Ocular Immunology and Inflammation

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“…Sarcoidosis is associated with an elevated overall relative risk for the development of malignancies, including lymphomas and solid tumors [10][11][12][13]. The association of multiple myeloma with sarcoidosis is rare and has been reported in only 14 patients, 13 of whom had BM involvement with multiple myeloma and one had an extramedullary plasmacytoma of the mesentery [14]. Two of the patients were diagnosed with simultaneous sarcoidosis and multiple myeloma [15,16].…”

Section: Discussionmentioning

confidence: 99%

“…Sarcoidosis represents a chronic disease of immunologic disturbance. This disturbance has been proposed to explain the relationship between sarcoidosis and lymphoid malignancies, and it is possible that a similar mechanism may lead to the development of other hematologic malignancies, including multiple myeloma [14]. Polyclonal hyper-gammaglobulinemia is a common feature in sarcoidosis patients [17] and may be due to continuous stimulation of B cells by activated CD4?…”

Section: Discussionmentioning

confidence: 99%

Atypical sarcoidosis diagnosed by bone marrow biopsy during renal workup for possible multiple myeloma

et al. 2012

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Sarcoidosis is a multi-organ disease of unknown etiology characterized by non-caseating granulomas. Here we report the case of a 78-year-old white male with a past medical history of diabetes mellitus, hypertension, and chronic kidney disease stage III with a baseline serum creatinine of 2.5 mg/dl. The patient had a prior admission history for acute kidney injury (AKI) attributed to dehydration and medication-induced nephro-toxicities. He presented to the renal clinic for follow-up with acute worsening of chronic kidney failure with a serum creatinine level of 3.5 mg/dl. Examination revealed that he was anemic and mildly hypercalcemic with suppressed parathyroid hormone and had proteinuria of 1.3 g per day. The computed tomography scan of the abdomen revealed right renal pelvic non-obstructing calculi. Serum protein electrophoresis revealed gammopathy with two distinct monoclonal peaks consisting of immunoglobulin G (IgG) kappa and IgG lambda, respectively. The kappa/lambda ratio was within normal limits, and urine protein electrophoresis showed no evidence of a monoclonal peak or Bence Jones proteins. Further workup for multiple myeloma, including bone marrow (BM) biopsy, revealed polyclonal plasma cells and B cells with no clonality. No morphological and immunephenotypic evidence of plasma cell dyscrasia was found, but BM biopsy did show numerous non-caseating granulomas consistent with sarcoidosis. Skin biopsy from non-scaly 6-mm skin colored papule also showed non-caseating granulomas. The patient had elevated angiotensinconverting enzyme levels (165 ug/l) and an erythrocyte sedimentation rate of 27 mm/h. Kidney biopsy did not show granulomas. The hypercalcemia, proteinuria, and AKI responded well after 2 weeks of 60 mg oral prednisone daily.

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Ocular adnexal and orbital amyloidosis: a case series and literature review

et al. 2015

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The purpose of the study was to describe the main clinical and epidemiologic characteristics, treatment options, and outcome in a large series of patients with periocular and orbital amyloidosis. This is a retrospective, descriptive, observational study of a case series of 14 patients with periocular and orbital amyloidosis and is a review of previously published cases with this diagnosis between September 2004 and January 2015. In this study, we analyzed our 14 patients in conjunction with 69 well-documented cases of orbital and/or periocular amyloidosis previously reported, with a total of 83. Of these, 54 were female (65.1 %), 28 male (33.7 %), and one with unspecified gender. The mean age at diagnosis was 54.9 years (range, 18-87). The localization of the amyloidosis was classified as superficial, deep and combined, with involvement of 53 (63.9 %), 26 (31.3 %), and four cases (4.8 %) in each group, respectively. The main findings in superficial amyloidosis were mass or tissue infiltration (84.9 %) and ptosis (30.2 %) and, in the cases with deep involvement, mass (65.4 %), proptosis (57.7 %), limited ocular movements (34.6 %), ocular displacement (30.8 %), and ptosis (26.9 %). The cases with combined involvement presented with signs and symptoms of the two groups. Regarding the outcome, 43 patients were reported stable after the diagnosis and 21 had recurrence or required new surgical procedures. Periocular and orbital amyloidosis is a rare disease that can present with a variety of symptoms and signs depending on the localization and extension of involvement. Its prompt recognition is important in order to investigate systemic disease, which will affect the prognosis of each case.

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Multiple myeloma with lacrimal gland amyloidosis and sarcoidosis

Cited by 14 publications

References 24 publications

Lacrimal Gland Amyloidosis: A Clinicopathological Correlation of a Rare Disorder and Review of Literature

Lacrimal Gland Amyloidosis: A Clinicopathological Correlation of a Rare Disorder and Review of Literature

Atypical sarcoidosis diagnosed by bone marrow biopsy during renal workup for possible multiple myeloma

Ocular adnexal and orbital amyloidosis: a case series and literature review

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