Multiple myeloma presenting as acute pancreatitis

Mishra, Shakti Bedanta; Azim, Afzal; Mukherjee, Arindam

doi:10.1016/j.ajem.2017.06.009

Cited by 9 publications

(7 citation statements)

References 2 publications

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“…Gastrointestinal signs and symptoms are also not considered classic for multiple myeloma, although there are multiple plausible mechanisms by which myeloma could affect the digestive system, including hypercalcemia and amyloid deposition. Mishra et al reported a case of a 36year-old male whose initial manifestation of multiple myeloma was an episode of acute pancreatitis [18]. McIntosh et al found a similar case in a 22-year-old pregnant woman who also had evidence of preeclampsia, nephrolithiasis, and renal insufficiency [19].…”

Section: Gastrointestinal Diseasementioning

confidence: 99%

Uncommon Presentations of Multiple Myeloma

Tathineni¹,

Cancarevic²,

Malik³

2020

Cureus

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Multiple myeloma is a rare malignancy that exhibits a wide range of possible clinical presentations. In recent years, with the advent of stem cell transplantation, the prognosis of patients with multiple myeloma has been increasing. We searched the literature for reports of atypical myeloma presentations to aid clinicians in formulating differential diagnoses and to increase the number of cases diagnosed early. There have been a number of reports of early ocular symptoms, including, but not limited to, proptosis, optic neuropathy, vision loss, retinal hemorrhage, and detachment. Neurological presentations included cranial nerve palsies, vertigo related to cerebellar involvement, and diabetes insipidus related to pituitary involvement. Among gastrointestinal manifestations, there are a number of reports of multiple myeloma presenting as acute and chronic pancreatitis. Mesenteric ischemia due to amyloidosis, acute abdomen, and hepatosplenomegaly were also among reported presentations. When it comes to renal involvement, while acute renal failure and proteinuria are typical, there are reports of patients presenting with both nephritic and nephrotic forms of glomerular disease, as well as end-stage renal disease requiring dialysis. We believe that it is essential for clinicians to keep reporting atypical multiple myeloma presentations and consider it as a possible diagnosis in a patient with serious, atypical symptoms.

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Section: Gastrointestinal Diseasementioning

confidence: 99%

Uncommon Presentations of Multiple Myeloma

Tathineni¹,

Cancarevic²,

Malik³

2020

Cureus

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“…Increased plasma levels of calcium may lead to AP through a block of enzymatic secretion and accumulation of digestive zymogens within the pancreatic acinar cells [83]. Common causes of hypercalcemia include hyperparathyroidism, malignancy (bone metastases, multiple myeloma, parathyroid carcinoma), vitamin D toxicity, sarcoidosis, familial hypocalciuric hypercalcemia, and total parenteral nutrition [84,85].…”

Section: Hypercalcemiamentioning

confidence: 99%

Idiopathic acute pancreatitis: a review on etiology and diagnostic work-up

Blanco

Gesuale

Varanese

et al. 2019

Clin J Gastroenterol

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Acute pancreatitis (AP) is a common disease associated with a substantial medical and financial burden, and with an incidence across Europe ranging from 4.6 to 100 per 100,000 population. Although most cases of AP are caused by gallstones or alcohol abuse, several other causes may be responsible for acute inflammation of the pancreatic gland. Correctly diagnosing AP etiology is a crucial step in the diagnostic and therapeutic work-up of patients to prescribe the most appropriate therapy and to prevent recurrent attacks leading to the development of chronic pancreatitis. Despite the improvement of diagnostic technologies, and the availability of endoscopic ultrasound and sophisticated radiological imaging techniques, the etiology of AP remains unclear in ~ 10-30% of patients and is defined as idiopathic AP (IAP). The present review aims to describe all the conditions underlying an initially diagnosed IAP and the investigations to consider during diagnostic work-up in patients with non-alcoholic non-biliary pancreatitis.

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“…Jang et al (5) reported that AP caused by IPMN was more likely to be mild. Several other authors had described acute pancreatitis as a reporting sign of pancreatic neuroendocrine tumor (pNET), non-Hodgkin's lymphoma (NHL), lung cancer, parathyroidoma, and multiple myeloma in case reports (4,7,8,19,20). But these studies did not include patients with a whole range of neoplastic causes and did not compare AP patients with and without the presence of a tumor.…”

Section: Discussionmentioning

confidence: 99%

“…The underlying mechanisms of tumor-associated AP were unclear. There were several pathogenetic hypotheses: (I) mechanical obstruction of the pancreatic duct due to the mass, lymphadenopathy or poor pancreatic juice drainage, (II) pancreatic ischemia caused by vascular compromise secondary to tumor invasion, (III) secondary to hypercalcemia caused by tumor (4,5,19). In a series of 66 patients, 75.8% had pancreatic neoplasms and almost 40% of these patients had obstruction of the MPD (26).…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and outcome of tumor-associated acute pancreatitis: a single-center cohort study

Xiong¹,

Zhao²,

Han³

et al. 2021

Ann Transl Med

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Background: What features should alert clinicians to suspect underlying tumors in patients with acute pancreatitis (AP) was largely unknown. This study aimed to assess the clinical characteristics and outcome in patients with tumor-associated AP.Methods: Patients who presented with AP and were diagnosed with tumor after admission were included according to the inclusion and exclusion criteria and followed up by hospital notes, telephone, WeChat and/ or e-mail. The clinical characteristics and outcome were analyzed with multivariable logistic regression and were compared with AP patients without tumor.Results: Out of a cohort of 1,792 AP patients we identified 103 who had a neoplastic etiology. The 103 patients had a median age of 57 (range, 13-81) and 65 were males. AP was mild in 92 patients, moderately severe in 7 and severe in 4. The three most common tumors included pancreatic cancer (PC) (40), periampullary carcinoma (PAC) (25), and neoplastic pancreatic cysts (NPC) (22). The following ranked features were predictive of a tumor etiology: dilation of main pancreatic duct (MPD) (

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Multiple myeloma presenting as acute pancreatitis

Cited by 9 publications

References 2 publications

Uncommon Presentations of Multiple Myeloma

Uncommon Presentations of Multiple Myeloma

Idiopathic acute pancreatitis: a review on etiology and diagnostic work-up

Clinical characteristics and outcome of tumor-associated acute pancreatitis: a single-center cohort study

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