Multiple myeloma with paraneoplastic leucocytoclastic vasculitis

Jain, Preetesh; Kumar, Priyank; Parikh, PM

doi:10.4103/0019-509x.49159

Cited by 11 publications

(5 citation statements)

References 4 publications

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“…This study found that all patients had IgG myeloma associated with LCV. In contrast, several case-reports described IgA myeloma associated with LCV [68] , [69] , [70] , [71] , [72] . Another report describes a patient who developed MM, retinal vasculitis and temporal arteritis [73] .…”

Section: Rheumatologic Disorders In Multiple Myelomamentioning

confidence: 88%

Autoimmune manifestations in patients with multiple myeloma and monoclonal gammopathy of undetermined significance

et al. 2016

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BackgroundMultiple myeloma (MM) and its precursor, monoclonal gammopathy of undetermined significance (MGUS), have been linked with several autoimmune conditions in the medical literature. Yet, significance of these associations is not well understood.MethodsHerein, we provide a comprehensive literature review on autoimmune disorders identified in patients with MM and MGUS. Most relevant papers were identified via searching the PubMed/Medline and EMBASE databases for articles published from inception until May 1, 2016.FindingsScientific literature on autoimmune conditions in patients with MM and MGUS consists of several case series and a multitude of case reports. Our analysis suggests an increased prevalence of autoimmune conditions in patients with MM and monoclonal gammopathy of undetermined significance (MGUS), including various autoimmune hematologic and rheumatologic conditions among other entities. Conversely, persons with various autoimmune conditions tend to have a higher prevalence of MGUS and MM than the general population.ConclusionsFuture research is required to explore further the link between MGUS/MM and autoimmune disorders. Inflammation in the setting of autoimmunity may serve as a trigger for MGUS and MM. In addition, a common genetic susceptibility for developing both an autoimmune disease and MM/MGUS might also exist. Autoimmune hematologic and rheumatologic diseases may pose important clinical problems for the MM patients. Therefore, a catalogue of these problems is important so that physicians are able to consider, identify and address them promptly.

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Section: Rheumatologic Disorders In Multiple Myelomamentioning

confidence: 88%

Autoimmune manifestations in patients with multiple myeloma and monoclonal gammopathy of undetermined significance

et al. 2016

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“… 28 , 70 , 86 Information on previously reported cases of cutaneous vasculitis occurring in the setting of an underlying hematologic neoplasia is summarized in Table 3 . 5 , 14 , 17 , 27 , 32 , 37 , 48 , 49 , 52 , 58 , 62 , 64 , 68 , 74 , 79 , 84 , 86 , 88 , 90 , 99 Castro et al 17 reported 7 cases of cutaneous vasculitis, 5 of them with histologically confirmed leukocytoclastic vasculitis, from a series of 162 patients with myelodysplastic syndrome. Most of them had refractory anemia with excess blasts.…”

Section: Discussionmentioning

confidence: 99%

The Spectrum of Paraneoplastic Cutaneous Vasculitis in a Defined Population

Loricera

Calvo-Río²,

Sanjuán³

et al. 2013

Medicine

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Cutaneous vasculitis may be associated with malignancies, and may behave as a paraneoplastic syndrome. This association has been reported in a variable proportion of patients depending on population selection. We conducted the current study to assess the frequency, clinical features, treatment, and outcome of paraneoplastic vasculitis in a large unselected series of 766 patients with cutaneous vasculitis diagnosed at a single university hospital.Sixteen patients (10 men and 6 women; mean age ± standard deviation, 67.94 ± 14.20 yr; range, 40–85 yr) presenting with cutaneous vasculitis were ultimately diagnosed as having an underlying malignancy. They constituted 3.80% of the 421 adult patients. There were 9 hematologic and 7 solid underlying malignancies. Skin lesions were the initial clinical presentation in all of them, and the median interval from the onset of cutaneous vasculitis to the diagnosis of the malignancy was 17 days (range, 8–50 d). The most frequent skin lesions were palpable purpura (15 patients). Other clinical manifestations included constitutional syndrome (10 patients) and arthralgia and/or arthritis (4 cases). Hematologic cytopenias (11 cases) as well as immature peripheral blood cells (6 cases) were frequently observed in the full blood cell count, especially in those with vasculitis associated with hematologic malignancies.Specific treatment for vasculitis was prescribed in 10 patients; nonsteroidal antiinflammatory drugs (4 patients), corticosteroids (3 patients), chloroquine (1 patient), antihistamines (1 patient), and cyclophosphamide (1 patient). Ten patients died due to the malignancy and 6 patients recovered following malignancy therapy. Patients with paraneoplastic vasculitis were older, more frequently had constitutional syndrome, and less frequently had organ damage due to the vasculitis than the remaining patients with cutaneous vasculitis.In summary, cutaneous paraneoplastic vasculitis is an entity not uncommonly encountered by clinicians. The most common underlying malignancy is generally hematologic. In these cases the presence of cytopenias and immature cells may be red flags for the diagnosis of cancer. In patients with paraneoplastic cutaneous vasculitis, the prognosis depends on the underlying neoplasia.

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“…En dehors de ces médicaments précités, d'autres traitements ont été à l'origine des VLC telle que la Gabapentine [13]. Les vascularites paranéoplasiques constituent 30 à 40% des vascularites cutanées [14]. La VLC est considérée comme la forme la plus fréquente des vascularites cutanées paranéoplasiques.…”

Section: Discussionunclassified

Vascularites cutanées leucocytoclasiques: à propos de 85 cas

Aounallah¹,

Arouss²,

Ghariani³

et al. 2017

Pan Afr Med J

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La présentation clinique, les étiologies et l'évolution des Vascularites leucocytoclasiques sont peu étudiées. L'objectif de notre travail est d'étudier les particularités épidémiologiques, cliniques, étiologiques et évolutives de cette entité. Nous avons mené une étude transversale portant sur 85 patients ayant une vascularite leucocytoclasique colligés dans le service de dermatologie de l'hôpital Farhat Hached de Sousse entre Janvier 2000 et Décembre 2013. Pour chaque patient, une fiche des données épidémiologiques, cliniques, paracliniques et étiologiques a été remplie. L'âge moyen de nos patients était de 47,65 ans avec des extrêmes allant de 10 à 78 ans. Cinquante trois femmes et 32 hommes étaient recensés (sexe ratio = 0,6). Les manifestations cutanées étaient dominées par le purpura vasculaire (88,2%). Les étiologies les plus fréquentes étaient les maladies systémiques (51%), les infections (20%) et les dermatoses neutrophiliques (14,5%). Les autres étiologies retrouvées étaient : les causes médicamenteuses (9,1%) et les hémopathies malignes (5,4%). Chez 30 patients (35,3%), l'étiologie n'a pas été retrouvée. Deux facteurs prédictifs à l'évolution aigue étaient retenus : la présence d'une infection récente (p= 0,014) et d'une prise médicamenteuse précédant l'éruption cutanée (p= 0,013). L'évolution chronique était corrélée positivement aux anticorps antinucléaires (p= 0,009), et à la cryoglobulinémie (p=0,025). Notre étude illustre la multitude des étiologies de vascularites leucocytoclasiques. La recherche d'une maladie sous-jacente est impérative afin de garantir une meilleure prise en charge thérapeutique.

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Multiple myeloma with paraneoplastic leucocytoclastic vasculitis

Cited by 11 publications

References 4 publications

Autoimmune manifestations in patients with multiple myeloma and monoclonal gammopathy of undetermined significance

Autoimmune manifestations in patients with multiple myeloma and monoclonal gammopathy of undetermined significance

The Spectrum of Paraneoplastic Cutaneous Vasculitis in a Defined Population

Vascularites cutanées leucocytoclasiques: à propos de 85 cas

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