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- W2892283421 abstract "Background: Multiple Myeloma (MM) is a plasma cell disorder that involves clonal proliferation of neoplastic plasma cells in the bone marrow with an increase in monoclonal paraproteins. It is uncommonly associated with extra-osseous involvement such as spleen or liver, especially at initial presentation. Here we present a rare case of acute liver failure (ALF) in a patient with MM. Methods: A 56-year-old female with a history of hypertension and hypothyroidism who was admitted to the hospital with complaint of 2 weeks of abdominal swelling, difficulty ambulating, lower extremity swelling, and shortness of breath. She noted a 15-pound weight loss over the last 2 months. She was found to have ascites, globulin gap, elevated serum total protein, hypoalbuminemia, anemia and renal failure concerning for cirrhosis. Results: CT abdomen and pelvis showed ascites, abnormal appearance of liver parenchyma, and enlargement of hepatic veins, suggestive of cirrhosis. She underwent liver biopsy which showed sinusoidal involvement of plasma cells concerning for MM with no evidence of hepatitis or cirrhosis. Cytology on peritoneal fluid also showed malignant plasma cells. Serum protein electrophoresis consistent with IgG lambda with M protein of 10. Bone marrow biopsy revealed hypercellular marrow with 80% plasma cells. There were multiple lesions throughout the skeleton consistent with multiple myeloma. Conclusion: MM presenting as ALF is extremely rare and only a few cases have ever been reported. Liver involvement can be seen and is discovered incidentally but is clinically silent. It is associated with poorer prognosis as treatment is limited with liver failure. It is important to consider MM in patients who present with ALF, especially with no risk factors for cirrhosis, since prompt diagnosis can lead to quicker treatment and theoretically improved survival." @default.
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- W2892283421 date "2018-03-01" @default.
- W2892283421 modified "2023-10-16" @default.
- W2892283421 title "Acute liver failure as initial presentation of multiple myeloma" @default.
- W2892283421 doi "https://doi.org/10.1016/j.hpb.2018.02.611" @default.
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