Autoimmune hemolytic anemia and hyperglobulinemia leading to the diagnosis of multiple myeloma

Pacca, Rafael Lopes; Silva, Jiviane Beatriz Cunha Barretto da; Souza, Kallen de Carvalho e; Carbinatto, Rebeca Barbosa

doi:10.1016/j.bjhh.2017.07.005

Cited by 4 publications

(2 citation statements)

References 6 publications

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“…6 Autoimmune hemolytic anemia and cold agglutination disease are rare presenting manifestations of MM. 7 8 Despite several reports showing the association between autoimmune hemolytic anemia and MM, none have shown conclusive evidence that the myeloma monoclonal protein is responsible, and rarely are they symptomatic due to the same. 9 There was evidence of transfusion-associated alloimmunization in our patient, which was confirmed by the identification of the anti-JK a antibody.…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Acute Hemolytic Anemia in a Patient with Newly Diagnosed Multiple Myeloma: Maintaining a Fine Balance between Occam's Razor and Hickam's Dictum

Ovett

Karunakaran

Kalaiyarasi

et al. 2022

Indian J Med Paediatr Oncol

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Anemia is a common feature in multiple myeloma and is multifactorial. A 52-year-old lady was admitted to our hospital with complaints of fatigue, exertional dyspnea, paresthesia, and a recent-onset confusion state. Fundus examination revealed features of hyperviscosity. The patient received 2 units of packed red blood cell transfusion (PRBC) before the present hospital admission. Laboratory investigations revealed severe anemia and thrombocytopenia. The M-protein was 5.8 g/dL. Bone marrow showed sheets of plasma cells. Immunofixation electrophoresis confirmed the presence of an IgAλ band. FISH was positive for IgH-FGFR3 fusion. The investigations confirmed multiple myeloma R-ISS stage III. The patient was immediately started on CyBorD chemotherapy regimen. The patient had indirect hyperbilirubinemia and symptomatic anemia. Initial testing of the patient's sample showed blood grouping discrepancy with DCT, ICT, and auto control positive. The symptomatic anemia persisted requiring PRC transfusions. Further antibody study revealed the presence of anti-Jka antibody—a warm IgG antibody and cold antibody. Subsequently, the patient received Jka antigen-negative B-positive compatible PRBC transfusions and the hemoglobin normalized. Our patient had transfusion-associated alloimmunization along with hyperviscosity. The timely recognition and early institution of plasmapheresis and myeloma-directed therapy along with transfusion of compatible Jka antigen-negative PRBC lead to rapid improvement.

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Section: Discussionmentioning

confidence: 99%

A Rare Case of Acute Hemolytic Anemia in a Patient with Newly Diagnosed Multiple Myeloma: Maintaining a Fine Balance between Occam's Razor and Hickam's Dictum

Ovett

Karunakaran

Kalaiyarasi

et al. 2022

Indian J Med Paediatr Oncol

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“…While some research indicates that AIHA is extremely infrequently related with MM, others assert that 4% of individuals with MM also have AIHA. A recent study revealed the presence of antibodies against erythrocyte surface antigens in 10.6% of the population under analysis, suggesting that the production of autoantibodies could be facilitated by concurrent immunological abnormalities in patients affected by MM [ 31 , 32 , 33 ].…”

Section: Physiopathology Of Autoimmune Diseases and Multiple Myelomamentioning

confidence: 99%

Autoimmune Diseases and Plasma Cells Dyscrasias: Pathogenetic, Molecular and Prognostic Correlations

Giordano,

Cacciola,

Barone

et al. 2024

Diagnostics

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Multiple myeloma and monoclonal gammopathy of undetermined significance are plasma cell dyscrasias characterized by monoclonal proliferation of pathological plasma cells with uncontrolled production of immunoglobulins. Autoimmune pathologies are conditions in which T and B lymphocytes develop a tendency to activate towards self-antigens in the absence of exogenous triggers. The aim of our review is to show the possible correlations between the two pathological aspects. Molecular studies have shown how different cytokines that either cause inflammation or control the immune system play a part in the growth of immunotolerance conditions that make it easier for the development of neoplastic malignancies. Uncontrolled immune activation resulting in chronic inflammation is also known to be at the basis of the evolution toward neoplastic pathologies, as well as multiple myeloma. Another point is the impact that myeloma-specific therapies have on the course of concomitant autoimmune diseases. Indeed, cases have been observed of patients suffering from multiple myeloma treated with daratumumab and bortezomib who also benefited from their autoimmune condition or patients under treatment with immunomodulators in which there has been an arising or worsening of autoimmunity conditions. The role of bone marrow transplantation in the course of concomitant autoimmune diseases remains under analysis.

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Autoimmune Hemolytic Anemia as Presenting Manifestation of Multiple Myeloma

Naithani

Dayal

2020

Indian J Hematol Blood Transfus

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Autoimmune hemolytic anemia and hyperglobulinemia leading to the diagnosis of multiple myeloma

Cited by 4 publications

References 6 publications

A Rare Case of Acute Hemolytic Anemia in a Patient with Newly Diagnosed Multiple Myeloma: Maintaining a Fine Balance between Occam's Razor and Hickam's Dictum

A Rare Case of Acute Hemolytic Anemia in a Patient with Newly Diagnosed Multiple Myeloma: Maintaining a Fine Balance between Occam's Razor and Hickam's Dictum

Autoimmune Diseases and Plasma Cells Dyscrasias: Pathogenetic, Molecular and Prognostic Correlations

Autoimmune Hemolytic Anemia as Presenting Manifestation of Multiple Myeloma

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