| Symptoms
& History
Physical
Findings
Stop
& Think
Lab
and X-Ray
Differential
Diagnosis
The
Disease
Treatment
Conclusions
Quiz
& Evaluation |
|
Etiology
and pathogenesis of multiple myeloma
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Progenitor cell is probably
a small B derived lymphocyte.
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Proliferation and survival of
the malignant plasma cells seems linked to IL-6.
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Produced by the malignant plasma
cells.
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Patients have high serum
levels.
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IL-6, causes accelerated
bone destruction by activating osteoclasts.
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Bone loss is major problem.
Pathological
fractures.
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There is generalized wastage
of bone as well as focal loss where the concentrations of plasma cells
are.
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A fascinating finding,
but of unknown significance, is that stromal bone marrow of cells of many
patients with multiple myeloma are infected with herpesvirus 8.
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Herpesvirus 8 is associated
with other B cell lymphomas and even Kaposi sarcoma.
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The balanced translocation,
t(4;14)(p16.3;q32) is present in about 30% of cases.
What about the clinical
course?
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