Amyloid arthropathy in multiple myeloma
The accumulation of amyloid in many organs of patients with multiple myeloma has been well documented, but much less attention has been directed to the presence of amyloid material in joints and in the substance of the skeleton itself. The present report is that of three patients with multiple myelo...
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| Published in | Japanese Journal of Clinical Immunology Vol. 17; no. 2; pp. 84 - 89 |
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| Main Author | |
| Format | Journal Article |
| Language | English |
| Published |
The Japan Society for Clinical Immunology
1994
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0911-4300 1349-7413 1349-7413 |
| DOI | 10.2177/jsci.17.84 |
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| Abstract | The accumulation of amyloid in many organs of patients with multiple myeloma has been well documented, but much less attention has been directed to the presence of amyloid material in joints and in the substance of the skeleton itself. The present report is that of three patients with multiple myeloma in whom the clinical findings of amyloid arthropathy developed. Amyloid infiltration in and about the joints was so extensive as to simulate the findings of rheumatoid arthritis. In two of them, the articular manifestations were present for several months prior to the diagnosis of multiple myeloma. The delay of the diagnosis resulted in the development of a fatal complication of multiple myeloma, renal failure, which was not always unavoidable. Due to the fact that amyloid arthropathy is a rare manifestation of systemic amyloidosis and simulates rheumatoid arthritis, its diagnosis may be easily overlooked. |
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| AbstractList | The accumulation of amyloid in many organs of patients with multiple myeloma has been well documented, but much less attention has been directed to the presence of amyloid material in joints and in the substance of the skeleton itself. The present report is that of three patients with multiple myeloma in whom the clinical findings of amyloid arthropathy developed. Amyloid infiltration in and about the joints was so extensive as to simulate the findings of rheumatoid arthritis. In two of them, the articular manifestations were present for several months prior to the diagnosis of multiple myeloma. The delay of the diagnosis resulted in the development of a fatal complication of multiple myeloma, renal failure, which was not always unavoidable. Due to the fact that amyloid arthropathy is a rare manifestation of systemic amyloidosis and simulates rheumatoid arthritis, its diagnosis may be easily overlooked. |
| Author | Kanoh, Tadashi |
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| References | 1) Wiernik, P. H.: Amyloid joint disease. Medicine, 51: 465-479, 1972. 13) Khojasteh, A., Arnold, L. K., Farhangi, M.: Bone lesions in primary amyloidosis. Am. J. Hematol., 7: 77-86, 1979. 3) Nashel, D. J., Widerlite, L. W., Pekin, T. J., Jr.: IgD myeloma with amyloid arthropathy. Am.. J. Med., 55: 426-430, 1973. 8) Ohta, H., Endo, K., Kanoh, T. et al.: Technetium-99m(V) DMSA uptake in amyloidosis. J. Nucl. Med., 30: 2049-2052, 1989. 14) 小阪昌明・井口敬一・増田健二郎・他4名:骨アミロイド症症例報告と文献的考察.日内会誌, 75: 537～545, 1986. 5) Kyle, R. A., Bayard, E. D.: Amyloidosis; Review of 236 cases. Medicine, 54: 271-299, 1975. 11) Sebert, J-L, Fardellone, P., Marie, A. et al.: Destructive spondylarthropathy in hemodialyzed patients: possible role of amyloidosis. Arthritis Rheum., 29: 301-303, 1986. 10) Fam, A. G., Lewis, A. J., Cowan, D. H.: Multiple myeloma and amyloid bone lesions complicating rheumatoid arthritis. J. Rheumatol., 8: 845-850, 1981. 12) Leonard, P. A., Clegg, D. O., Lee, R. G.: Erosive arthritis in a patient with amyloid arthropathy. Clin. Rheumatol., 4: 212-217, 1985. 4) 中沢了一: Bone and joint involvement in systemic amyloidosis.日本臨床, 49: 138～143, 1991. 7) Gerzt, M. A., Kyle, R. A.: Primary systemic amyloidosis-a diagnostic primer. Mayo Clin. Proc., 64: 1505-1519, 1989. 9) 加納 正:骨髄腫と特発性単クローン性免疫グロブリン血症の境界領域をどのように考えるか.日臨免誌, 6: 352～358, 1983. 6) Kazt, G. A., Peter, J. B., Pearson, C. M. et al.: The shoulder-pad sign. -a diagnostic feature of amyloid arthropathy. N. Engl. J. Med., 288: 354-355, 1973. 2) Cohen, A. S., Canoso, J. J.: Rheumatological aspects of amyloid disease. Clin. Rheumat. Dis., 1: 149-161, 1975. |
| References_xml | – reference: 10) Fam, A. G., Lewis, A. J., Cowan, D. H.: Multiple myeloma and amyloid bone lesions complicating rheumatoid arthritis. J. Rheumatol., 8: 845-850, 1981. – reference: 8) Ohta, H., Endo, K., Kanoh, T. et al.: Technetium-99m(V) DMSA uptake in amyloidosis. J. Nucl. Med., 30: 2049-2052, 1989. – reference: 7) Gerzt, M. A., Kyle, R. A.: Primary systemic amyloidosis-a diagnostic primer. Mayo Clin. Proc., 64: 1505-1519, 1989. – reference: 3) Nashel, D. J., Widerlite, L. W., Pekin, T. J., Jr.: IgD myeloma with amyloid arthropathy. Am.. J. Med., 55: 426-430, 1973. – reference: 11) Sebert, J-L, Fardellone, P., Marie, A. et al.: Destructive spondylarthropathy in hemodialyzed patients: possible role of amyloidosis. Arthritis Rheum., 29: 301-303, 1986. – reference: 14) 小阪昌明・井口敬一・増田健二郎・他4名:骨アミロイド症症例報告と文献的考察.日内会誌, 75: 537～545, 1986. – reference: 13) Khojasteh, A., Arnold, L. K., Farhangi, M.: Bone lesions in primary amyloidosis. Am. J. Hematol., 7: 77-86, 1979. – reference: 4) 中沢了一: Bone and joint involvement in systemic amyloidosis.日本臨床, 49: 138～143, 1991. – reference: 1) Wiernik, P. H.: Amyloid joint disease. Medicine, 51: 465-479, 1972. – reference: 2) Cohen, A. S., Canoso, J. J.: Rheumatological aspects of amyloid disease. Clin. Rheumat. Dis., 1: 149-161, 1975. – reference: 6) Kazt, G. A., Peter, J. B., Pearson, C. M. et al.: The shoulder-pad sign. -a diagnostic feature of amyloid arthropathy. N. Engl. J. Med., 288: 354-355, 1973. – reference: 5) Kyle, R. A., Bayard, E. D.: Amyloidosis; Review of 236 cases. Medicine, 54: 271-299, 1975. – reference: 9) 加納 正:骨髄腫と特発性単クローン性免疫グロブリン血症の境界領域をどのように考えるか.日臨免誌, 6: 352～358, 1983. – reference: 12) Leonard, P. A., Clegg, D. O., Lee, R. G.: Erosive arthritis in a patient with amyloid arthropathy. Clin. Rheumatol., 4: 212-217, 1985. |
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| Title | Amyloid arthropathy in multiple myeloma |
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