Open AccessHepatic failure caused by plasma cell infiltration in multiple myeloma
Author(s) -
Fadi Rahhal,
Robert R. Schade,
Asha Nayak,
Teresa Coleman
Publication year - 2009
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.15.2038
Subject(s) - medicine , cholestasis , multiple myeloma , plasma cell myeloma , liver biopsy , infiltration (hvac) , plasma cell , autopsy , dexamethasone , biopsy , thalidomide , gastroenterology , liver failure , pathology , liver dysfunction , liver injury , physics , thermodynamics
Although plasma cell infiltration is not rare in autopsy of patients with multiple myeloma (MM), it is very rarely detected in living patients. This is because MM rarely causes significant liver dysfunction that requires further evaluation. A 49-year-old man presented with acute renal failure and was diagnosed with kappa light chain MM stage IIB. Thalidomide and dexamethasone were initiated. The patient developed a continuous increase in bilirubin that led to severe cholestasis. A liver biopsy revealed plasma cell infiltration. He then rapidly progressed to liver failure and died. Treatment options are limited in MM with significant liver dysfunction. Despite new drug therapies in MM, those patients with rapidly progressive liver failure appear to have a dismal outcome.