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

Bila, Jelena; Suvajdžić, Nada; Elezović, Ivo; Čolović, Milica; Bosković, D

doi:10.1007/s12032-007-0047-3

Cited by 10 publications

(6 citation statements)

References 36 publications

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“…(47) However, there are multiple reports of IgA myeloma occuring in younger patients with autoimmune disease. (4, 7, 17, 31, 43) Some of these cases appear to overlap with IgA nodal plasmacytomas in having a low risk of lytic bone disease but generalized lymphadenopathy. (7)…”

Section: Discussionmentioning

confidence: 99%

Nodal and Extranodal Plasmacytomas Expressing Immunoglobulin A

Shao

Raffeld

et al. 2010

American Journal of Surgical Pathology

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Plasmacytomas expressing immunoglobulin A are rare and not well characterized. In this study, nine cases of IgA-positive plasmacytomas presenting in lymph node and three in extranodal sites were analyzed by morphology, immunohistochemistry, and PCR examination of immunoglobulin heavy and kappa light chain genes. Laboratory features were correlated with clinical findings. There were seven males and five females; age range was 10 to 66 years (median, 32 years). Six of the patients were younger than 30-years-old, five of whom had nodal disease. 67% (6/9) of the patients with nodal disease had evidence of immune system dysfunction, including human immunodeficiency virus (HIV) infection, T-cell deficiency, autoantibodies, arthritis, Sjögren's syndrome, and decreased B-cells. An IgA M-spike was detected in 6/11 cases, and the M-protein was nearly always less than 30 g/L. All patients had an indolent clinical course without progression to plasma cell myeloma. Histologically, IgA plasmacytomas showed an interfollicular or diffuse pattern of plasma cell infiltration. The plasma cells were generally of mature Marschalko type with little or mild pleomorphism and exclusive expression of monotypic IgA. There was an equal expression of kappa and lambda light chains (ratio 6:6). Clonality was demonstrated in 9 of 12 cases: by PCR in 7 cases, by cytogenetic analysis in 1 case, and by immunofixation in 1 case. Clonality did not correlate with pattern of lymph node infiltration. Our results suggest that IgA plasmacytomas may represent a distinct form of extramedullary plasmacytoma characterized by younger age at presentation, frequent lymph node involvement and low risk of progression to plasma cell myeloma.

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Section: Discussionmentioning

confidence: 99%

Nodal and Extranodal Plasmacytomas Expressing Immunoglobulin A

Shao

Raffeld

et al. 2010

American Journal of Surgical Pathology

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“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14] The pathogeneses of SLE and SS are similar, suggesting that aberrations in T and B cells could lead to polyclonal B cell hyperactivity, hyperglobulinemia, and autoantibody production. However, none of the cases of SLE and MM in the literature were diagnosed with SS, and only one case 14 mentioned Ro/SS-A and Ro-52 antibody positivity in the autoimmune serological test.…”

Section: Discussionmentioning

confidence: 99%

Multiple Myeloma Secondary to Systemic Lupus Erythematosus and Sjögren's Syndrome: A Case Report

2014

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Patients with rheumatic diseases are at an increased risk for malignant lymphoproliferative disease, but the coexistence of rheumatic diseases and multiple myeloma is uncommon. Herein, we report a rare case of systemic lupus erythematosus and Sjögren's syndrome, which preceded the development of multiple myeloma after three years. We also summarize the clinical features of this case and discuss the possible pathogenetic mechanisms that underlie this unusual association.

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“…After eliminating two non‐English studies and three case reports written in Korean and French, plus the two cases reported herein, there were 15 cases of SLE with MM (Table 3 ). 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 …”

Section: Literature Reviewmentioning

confidence: 99%

“…MM primarily presents with microscopic hematuria, proteinuria, ostealgia, bone fractures, lymph node enlargement, an elevated serum calcium level, elevated monoclonal IgG, and abnormal kidney function. Case 11 12 was only diagnosed with monoclonal gammopathy of undetermined significance (MGUS) alone until confirmation of MM 8 years later. The diagnostic methods for MM include bone marrow biopsy, kidney biopsy, and immunofixation electrophoresis.…”

Section: Literature Reviewmentioning

confidence: 99%

Systemic lupus erythematosus associated with multiple myeloma: Two case reports and a literature review

Wang

2022

Immunity Inflam & Disease

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Introduction Systemic lupus erythematosus (SLE) complicated by multiple myeloma (MM) is a relatively rare clinical presentation, and is easily ignored due to their similar or even identical manifestation, which may lead to misdiagnosis and mistreatment. Case report We report two cases of SLE with MM. Case 1 was a 59‐year‐old male who was diagnosed with SLE 11 years ago. Abnormal kidney function was detected 4 months ago and a bone marrow aspirate revealed MM. He then received three cycles of bortezomib, dexamethasone, and chemotherapy with liposomal doxorubicin, and one cycle of lenalidomide plus dexamethasone. He died of infectious shock. Case 2 was a 58‐year‐old female who was diagnosed with SLE 27 years ago. After the onset of abnormal renal function 4 years ago, the patient was still treated according to SLE disease activity. When renal function rapidly deteriorated, serum and urine immunofixation electrophoresis was positive for IgG γ with free light chains and she was diagnosed with SLE complicated by MM. She did not agree to the treatment for MM as advised and was discharged from the hospital against medical advice. Case 2 died of cardiac failure. Thirteen cases of SLE with MM reported from 2000 to 2022 in PUBMED and Mendeley and our above two cases were reviewed. Among the 15 patients, 13 were females and 2 were males. The median age at the time of SLE with MM diagnosis was 50 years, and the median time to a delayed diagnosis was 7 years. The serum monoclonal immunoglobulin level was elevated and extramedullary manifestations of renal dysfunction were common. Conclusions An elevated monoclonal immunoglobulin level or newly unexplained renal dysfunction occurring in a patient with SLE should prompt monitoring and further screening of MM, rather than treatment as a secondary manifestation of SLE.

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

Cited by 10 publications

References 36 publications

Nodal and Extranodal Plasmacytomas Expressing Immunoglobulin A

Nodal and Extranodal Plasmacytomas Expressing Immunoglobulin A

Multiple Myeloma Secondary to Systemic Lupus Erythematosus and Sjögren's Syndrome: A Case Report

Systemic lupus erythematosus associated with multiple myeloma: Two case reports and a literature review

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