The Association between Multiple Myeloma and Ankylosing Spondylitis: A Report of Two Cases

Abstract

Multiple myeloma is a malignant disease of plasma cells, whereas ankylosing spondylitis is a chronic inflammatory disease of axial joints. The relationship between the two diseases is uncertain, but chronic inflammation could trigger multiple myeloma. The authors report the cases of two ankylosing spondylitis patients with a disease duration of more than 20 years, that subsequently developed IgA kappa and IgG lambda chain myeloma, respectively, and discuss the possible pathogenetic relationship between these diseases. (Korean J Hematol 2009;44:182-187.)

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

“…A retrospective cohort of over 4 million United States (US) white and black male veterans followed for 27 years found a significantly increased relative risk of 2.29 of developing MM and MGUS in subjects with AS [46] . Several reports describe development of MM in patients with longstanding AS [61] , [62] , [63] , [64] , [65] , [66] . Among those cases, one patient had IgA lambda and five patients had IgA kappa multiple myeloma.…”

Development of multiple myeloma in a case of longstanding ankylosing spondylitis: more than a coincidence?

“…There are a few case reports of occurrence of MM in AS of long duration. In the literature, six cases of myeloma have been reported in patients of AS who have not received any radiation: four case reports of secretory multiple myeloma and two cases of non‐secretory myeloma 1–6 . Among these, five were of the Ig A kappa variety and one Ig A lambda myeloma.…”

“…In the literature, six cases of myeloma have been reported in patients of AS who have not received any radiation: four case reports of secretory multiple myeloma and two cases of non-secretory myeloma. [1][2][3][4][5][6] Among these, five were of the Ig A kappa variety and one Ig A lambda myeloma. In all these patients, the onset of symptoms of ankylosing spondylitis preceded the diagnosis of myeloma by many years (average 22 years).…”