Pernicious Anaemia, Paraproteinaemia With Unusual Features, and Chromosome Aberrations

Kjeldsen, Knud; Clausen, J.; Frøland, Anders

doi:10.1111/j.0954-6820.1969.tb01465.x

Cited by 7 publications

(3 citation statements)

References 26 publications

(12 reference statements)

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“…Pernicious anaemia has been reported in a case of IgG and IgM paraproteinemia of the kappa type as well as IgA multiple myeloma. [ 3 ]. There are several reported mechanisms for the development of B12 deficiency in patients with myeloma which include the following:…”

Section: Discussionmentioning

confidence: 99%

“…Multiple myeloma is a clonal malignancy of plasma cells characterized by an overproduction of monoclonal antibodies [ 1 ]. The IgG and IgM paraproteinemia of the kappa type as well as IgA myeloma have been linked with pernicious anaemia [ 1 – 3 ]. Generation of specific autoreactive antibodies, anti-intrinsic-factor-like activity of the IgM paraprotein, increased tumour burden, immunomodulatory properties of lenalidomide, and disruption of renal mechanisms of B12 absorption are some of the described mechanisms by which B12 deficiency can occur in these patients [ 1 , 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Rapid Onset of B12 Deficiency in the Setting of Worsening Multiple Myeloma: Correlations between B12 Deficiency and Multiple Myeloma

Seegobin

Maharaj

Nelson

et al. 2017

Case Reports in Oncological Medicine

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A 67-year-old female with a relapse of multiple myeloma after being in remission for approximately 2 years following autologous stem cell transplant presented with worsening pancytopenia, over a three-month period. There were an increase in her monoclonal spike at 3.13 g/dL on serum protein electrophoresis, low serum B12 levels, and positive intrinsic factor antibodies. Three months before, she had normal B12 levels and a significantly lower monoclonal spike of 1.07 g/dL. She was diagnosed with B12 deficiency with pernicious anaemia in the setting of her worsening myeloma. Multiple myeloma (MM) has been linked with B12 deficiency and pernicious anaemia. Several mechanisms have been described regarding the pathogenesis of B12 deficiency in such patients. Increased tumour activity can further perpetuate the development of B12 deficiency in such patients. With regard to our case, the increase in tumour activity and onset of pernicious anaemia could have contributed to the rapid development of B12 deficiency. In contrast to this, rapid development of B12 deficiency could also signify relapse or worsening of the myeloma as seen in our case. Physicians ought to consider B12 deficiency in patients with worsening pancytopenia and myeloma.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Rapid Onset of B12 Deficiency in the Setting of Worsening Multiple Myeloma: Correlations between B12 Deficiency and Multiple Myeloma

Seegobin

Maharaj

Nelson

et al. 2017

Case Reports in Oncological Medicine

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“…Hyperparathyroidism should be ruled out since MGUS has disappeared after the removal of parathyroid adenomata (55). Since B12 deficiency is known to be associated with MGUS, a test of B12 absorption should be made, and B12 should be measured in the blood (56,57). Naturally, all chronic infections should be treated.…”

Section: Discussionmentioning

confidence: 99%

Neuropathy and motor neuron syndromes associated with plasma cell disease

Patten

2009

Acta Neurologica Scandinavica

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Increasing numbers of patients are being recognized with neurological abnormalities associated with the immunochemical changes of plasma cell disease. To illustrate the wide spectrum of clinical disorders that can be found, I discuss in detail 5 patients: 2 with neuropathy, 3 with amyotrophic lateral sclerosis (ALS), all of whom had serum monoclonal paraproteinemia. In addition, I report in tabular form 6 patients with paraproteinemia and the following clinical presentations: 1) systemic lupus with polyneuropathy and severe cerebritis, 2) myasthenia gravis with thymoma, 3) polymyositis, 4) polymyositis, arthritis and Grave's disease, ) relapsing polyneuritis (one of the original patients diagnosed by Austin) and 6) ALS, dystonia and parkinsonism.Major improvements in clinical condition occurred sometimes, but not always, coincident with reductions in the levels of the paraprotein using prednisone, cyclophophamide, chlorambucil and plasma exchange treatments even in some of the patients who had the clinical appearance of ALS. Patients with neuromuscular diseases should be routinely screened with serum immunoelectrophoresis for monoclonal gammopathy. If a monoclonal gammopathy is found and if the disease is serious, then those patients should be treated as if they had an autoimmune disorder.

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Idiopathic (Asymptomatic) Monoclonal Gammopathies

Ritzmann¹

1975

Arch Intern Med

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Pernicious Anaemia, Paraproteinaemia With Unusual Features, and Chromosome Aberrations

Cited by 7 publications

References 26 publications

Rapid Onset of B12 Deficiency in the Setting of Worsening Multiple Myeloma: Correlations between B12 Deficiency and Multiple Myeloma

Rapid Onset of B12 Deficiency in the Setting of Worsening Multiple Myeloma: Correlations between B12 Deficiency and Multiple Myeloma

Neuropathy and motor neuron syndromes associated with plasma cell disease

Idiopathic (Asymptomatic) Monoclonal Gammopathies

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