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Background: Multiple myeloma (MM) is a malignant neoplasm associated with kidney involvement in nearly half of the patients. Cast nephropathy, monoclonal immunoglobulin deposition disease (MIDD), and light chain (AL) amyloidosis are the most common monoclonal immunoglobulin-mediated causes of renal injury. Cardiac involvement is also present in MM, characterized by restrictive cardiomyopathy generated by light chain deposit or amyloid. Thromboembolic complications such as deep vein thrombosis or pulmonary embolism are also described.
Case Presentation: We present an unusual multidisciplinary case of a woman with a newly diagnosed MM associated with severe proteinuria and high natriuretic peptide. A renal and fat pad biopsy with Congo red staining were performed but amyloid deposition was not discovered. While immunofluorescence on fresh frozen unfixed tissue was not contributory, the immunofluorescence on fixed tissue and electron microscopy revealed the correct diagnosis. During subsequent investigations, two intracardiac right-sided masses and massive pulmonary embolism were also detected.
Conclusions: This case highlights that multiple organ involvement in patients with MM may result from a combination of paraprotein-dependent and -independent factors. Moreover, renal diseases induced by monoclonal gammopathies are a group of complex and heterogeneous disorders. Their subtle presentation and their potential multiorgan involvement require the expertise of a multidisciplinary team able to provide the most appropriate diagnostic and therapeutic assessment.
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http://dx.doi.org/10.1186/s12882-022-02984-4 | DOI Listing |
Catheter Cardiovasc Interv
December 2024
Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China.
Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide, particularly among complex high-risk and indicated patients (CHIP). Revascularization is often beneficial for these patients; however, it requires thorough risk stratification and close multidisciplinary collaboration between cardiologists and cardiac surgeons to optimize outcomes. Personalized treatment plans, including percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG), are crucial in this context.
View Article and Find Full Text PDFPacing Clin Electrophysiol
December 2024
Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
This case report presents the management of tachycardiomyopathy (TCM) in a patient with Friedreich ataxia, a hereditary disorder characterized by progressive neurodegeneration and associated cardiac complications. The patient exhibited severe tachycardia-induced cardiac dysfunction, complicating the clinical picture due to the overlapping neurological symptoms of Friedreich ataxia. Utilizing a 3D mapping system, catheter ablation was performed to accurately identify and target the arrhythmogenic foci contributing to the patient's TCM.
View Article and Find Full Text PDFInterv Pain Med
December 2024
University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY, 14623, USA.
Background: Cervical interlaminar epidural steroid injections (CIESI) are frequently used to treat cervical radiculopathy due to cervical nerve root impingement.
Objective: The purpose of this study was to evaluate the therapeutic effect of CIESI for patients with cervical radiculopathy.
Methods: We conducted a retrospective review of consecutive adult patients with cervical radicular pain and corroborative cervical spondylotic foraminal stenosis on MRI that failed at least 6 weeks of conservative management consisting of medication and physical rehabilitation seen at a multidisciplinary, tertiary academic spine center.
Case Rep Oncol Med
December 2024
Oncology Unit Fondazione, IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
This case series highlights the complexity of sarcoidosis-like reactions (SLRs) during cancer treatment, specifically in patients receiving immunotherapy or targeted therapies for melanoma. SLRs can either mimic disease progression or present as part of the clinical manifestation, making diagnosis and treatment challenging. Our study reviewed the medical records of 31 patients who were candidates for postoperative treatment between June 2022 and June 2024.
View Article and Find Full Text PDFCureus
November 2024
Department of Multidisciplinary Internal Medicine, Division of Respiratory Medicine and Rheumatology, School of Medicine, Faculty of Medicine, Tottori University, Tottori, JPN.
A saber-sheath trachea is a type of tracheal deformity characterized by coronal narrowing and sagittal widening of the intrathoracic trachea. In this case report, we describe a 76-year-old man with a history of chronic obstructive pulmonary disease (COPD) and repeated episodes of type 2 respiratory failure that responded poorly to inhaled long-acting β2 agonists, long-acting muscarinic antagonists, and corticosteroids. The patient was admitted to our hospital due to a COPD exacerbation.
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