Document Detail


Hyperlipidemic myeloma: review of 53 cases.
MedLine Citation:
PMID:  19921193     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hyperlipidemic myeloma is a rare and poorly understood variant of multiple myeloma. We report the case of a 53-year-old woman with hyperlipidemic myeloma, skin xanthomas and hyperviscosity syndrome who underwent allogeneic bone marrow transplantation. A comprehensive literature search identified 52 additional cases with plasma cell disease and hyperlipidemia. A detailed analysis revealed several characteristics of these patients as compared to multiple myeloma with normal lipid status: (1) IgA paraprotein was present in the majority (53% vs. 21% in classical multiple myeloma). (2) Skin xanthomas, especially in the palmar creases, elbows, and knees were common (70%). (3) Hyperviscosity syndrome occurred more often (26% vs. 2-6%). While conventional lipid-lowering therapy had only marginal effects, successful anti-myeloma therapy also reduced hyperlipidemia. Analyses of the mechanisms leading to hyperlipidemia documented complexes of paraprotein and lipoprotein in 75% of the 32 cases tested, suggesting an inhibitory role of the paraprotein on lipid degradation. In conclusion, the clinical characteristics, the therapeutic options, and the pathophysiologic mechanisms of hyperlipidemic myeloma are comprehensively reported using the available data from all 53 published cases in the literature.
Authors:
Benjamin Misselwitz; Jeroen S Goede; Bernhard C Pestalozzi; Urs Schanz; Jörg D Seebach
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2009-11-17
Journal Detail:
Title:  Annals of hematology     Volume:  89     ISSN:  1432-0584     ISO Abbreviation:  Ann. Hematol.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-04-16     Completed Date:  2010-04-27     Revised Date:  2010-07-29    
Medline Journal Info:
Nlm Unique ID:  9107334     Medline TA:  Ann Hematol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  569-77     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, University Hospital Zürich, Rämistr 100, 8091 Zürich, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Female
Hematopoietic Stem Cell Transplantation / adverse effects
Humans
Hyperlipidemias / complications*,  diagnosis*,  etiology,  metabolism
Middle Aged
Multiple Myeloma / complications*,  diagnosis*,  etiology,  metabolism
Paraproteins / metabolism
Skin Diseases / complications,  diagnosis
Transplantation, Homologous / adverse effects
Xanthomatosis / complications,  diagnosis
Chemical
Reg. No./Substance:
0/Paraproteins
Comments/Corrections
Comment In:
Ann Hematol. 2010 Sep;89(9):939-40   [PMID:  20127090 ]

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