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Unique Identifier 86170209
Authors Camacho J. Arnalich F. Anciones B. Pena JM. Gil A. Barbado FJ. Puig JG. Vazquez JJ.
Institution Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City.
Title: The spectrum of neurological manifestations in myeloma.
Source: Journal of Medicine. 16(5-6):597-611, 1985.
Abstract: Thirty-two patients with myelomatosis (3 with a solitary plasmocytoma and 29 with multiple myeloma) and neurological complications, from a group of 110 unselected patients with myelomatous disease were recorded. Spinal cord compression was the most frequent complication seen in 12 cases. In 9 subjects, it was the presenting symptom, and in 11 cases was caused by extradural plasmocytoma of the thoracic spine. Early decompressive laminectomy was curative in 3 cases, but in the rest, delay in diagnosis resulted in only partial recovery even with radiotherapy. Of the 6 patients with nerve root involvement, radiotherapy led to full recovery in 2 of 3 cases, and laminectomy resulted in complete improvement in 2 other cases. Peripheral polyneuropathy was seen in 8 cases, 2 related to systemic amyloidosis and 6 unassociated with amyloidosis. Both forms of neuropathy shared a slow progression, independent of the course of the myeloma. Acute encephalopathy, found in 6 cases, was due to hypercalcemia and/or serum hyperviscosity, and led to a significant shortening of mean survival. One patient had third cranial nerve palsy due to the overlying lesion of the skull base, and another suffered acute bacterial meningitis.

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Unique Identifier 84278843
Authors Smith BJ. Doukas M. Hess C. Savory J. Wills MR.
Institution Department of Medicine, Los Angeles County-University of Southern California Medical Center.
Title: Frequency of calcium binding by monoclonal immunoglobulins in multiple myeloma.
Source: Annals of Clinical & Laboratory Science. 14(4):261-4, 1984 Jul-Aug.
Abstract: Total and ionized calcium and other related parameters were measured in 34 patients with multiple myeloma. Hypercalcemia was not a major feature of the group of patients studied with only three patients exhibiting marked increases in total (Ca total) and ionized (Ca++) calcium concentrations. The Ca++/Ca total ratio was also maintained within relatively narrow limits. No major differences were found in the calcium fractions of patients with different types of multiple myeloma. Serum immunoreactive parathyroid hormone showed no consistent relationship with either the total or ionized calcium concentration. There were no correlations between increased total protein or reduced serum albumin concentrations and changes in total and ionized calcium fractions or Ca++/Ca total ratios. These results imply that in this group of myeloma patients, there was no significant binding of calcium by the monoclonal immunoglobulins.

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