Fast Five Quiz: Are You Prepared to Confront Multiple Myeloma?

Emmanuel C Besa, MD; Dhaval Shah, MD

Disclosures

March 09, 2017

Bone pain is the most common presenting symptom. Approximately 70% of patients have bone pain at presentation. The lumbar spine is one of the most common sites of pain.

Occasionally, a patient may come to medical attention for bleeding resulting from thrombocytopenia. Rarely, monoclonal protein may adsorb clotting factors and lead to bleeding.

Abnormal humoral immunity and leukopenia may lead to infection. Pneumococcal organisms are commonly involved, but shingles (ie, herpes zoster) and Haemophilus infections are also more common among patients with multiple myeloma.

Hyperviscosity may be associated with a number of symptoms, including generalized malaise, infection, fever, paresthesia, sluggish mentation, and sensory loss. Patients may report headaches and somnolence, and they may bruise easily and have hazy vision. Patients with multiple myeloma typically experience these symptoms when their serum viscosity is greater than four times that of normal serum. However, hyperviscosity is a rare complication of multiple myeloma and is more commonly seen in lymphoproliferative disorders such as Waldenstrom macroglobulinemia, which is associated with immunoglobulin M gammopathy.

For more on the presentation of multiple myeloma, read here.

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