A case report of AL amyloidosis complicated with multiple myeloma with dysphagia as the first symptom

doi:10.19438/j.cjoms.2023.01.017

Abstract

Abstract: Systemic light-chain-type amyloidosis combined with multiple myeloma(MM) is a clinically rare plasma cell-associated malignant disease. Most of the patients with this disease are complained for heart/renal impairment or substantial myeloma, and very few cases presented dysphagia or other oral related diseases as the first symptom, so it is easy to miss diagnosis or make misdiagnosis during first visit. Therefore, the diagnosis and treatment of amyloidosis with dysphagia was reported in the article. Based on the relevant literature review, the characteristics, diagnostic criteria and treatment of the disease were discussed.

Key words: Amyloidosis, Multiple myeloma, Dysphagia, Diseases of tongue, Oromaxillofacial region

CLC Number:

R739.8

CHEN Lin, CHEN Yin-yu, DING Zi-xue, MENG Jian. A case report of AL amyloidosis complicated with multiple myeloma with dysphagia as the first symptom[J]. China Journal of Oral and Maxillofacial Surgery, 2023, 21(1): 97-101.

References

[1] Westermark P, Benson MD, Buxbaum JN, et al.Amyloid: toward terminology clarification.Report from the nomenclature committee of the International Society of Amyloidosis[J].Amyloid, 2005, 12(1):1-4.
[2] 中国医师协会血液科医师分会,中华医学会血液学分会. 中国多发性骨髓瘤诊治指南(2022年修订)[J]. 中华内科杂志, 2022, 61(5): 480-487.
Chinese Hematology Association,Chinese Society of Hematology. Guidelines for the diagnosis and management of multiple myeloma in China(2022 revision)[J].Chinese Journal of Internal Medicine,2022,61(5):480-487.
[3] 于澈,赵雪,王荣. 175例淀粉样变性患者临床特点及预后分析[J]. 中华肾脏病杂志,2021, 37(3): 224-228.
Yu C, Zhao X, Wang R.Clinical characteristics and prognosis analysis of 175 patients with amyloidosis[J]. Chinese Journal of Nephrology, 2021, 37(3): 224-228.
[4] Maturana-Ramírez A, Ortega AV, Labbé FC, et al.Macroglossia, the first manifestation of systemic amyloidosis associated with multiple myeloma: case report[J]. J Stomatol Oral Maxillofac Surg, 2018, 119(6): 514-517.
[5] 中国系统性轻链型淀粉样变性协作组,国家肾脏疾病临床医学研究中心,国家血液系统疾病临床医学研究中心. 系统性轻链型淀粉样变性诊断和治疗指南(2021年修订)[J]. 中华医学杂志,2021,101(22):1646-1656.
China Collaboration Group on Systemic Light Chain amyloidosis, National Clinical Medical Research Center for Renal Diseases, National Clinical Medical Research Center for Hematological Diseases. Guidelines for the diagnosis and treatment of systemic light chain amyloidosis (revised 2021)[J].National Medical Journal of China, 2021, 101(22): 1646-1656.
[6] Rajkumar SV, Dimopoulos MA, Palumbo A, et al.International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma[J]. Lancet Oncol, 2014, 15(12): e538-e548.
[7] Li T, Huang X, Wang Q, et al.A risk stratification for systemic immunoglobulin light-chain amyloidosis with renal involvement[J] Br J Haematol, 2019, 187(4):459-469.
[8] Merlini G, Dispenzieri A, Sanchorawala V, et al.Systemic immunoglobulin light chain amyloidosis[J]. Nat Rev Dis Primers, 2018, 4(1): 38-43.
[9] Benson MD, Liepnieks JJ, Kluve-Beckerman B.Hereditary systemic immunoglobulin light-chain amyloidosis[J]. Blood, 2015, 125(21): 3281-3286.
[10] 李晨菲, 葛英辉. 心脏磁共振在心脏淀粉样变诊断中应用研究进展[J]. 中华实用诊断与治疗杂, 2021, 35(10): 985-987.
Li CF, Ge YH.Application of cardiac MRI in the diagnosis of cardiac amyloidosis[J].Journal of Chinese Practical Diagnosis and Therapy, 2021,35(10): 985-987.
[11] Diao X, Li J, Ouyang J, et al.Flow cytometry-based immunophenotypic analysis of primary systemic light chain amyloidosis[J]. Oncol Lett, 2017, 13(4):2691-2697.
[12] Kumar S, Paiva B, Anderson KC, et al.International Myeloma Working Group consensus criteria for response and minimal residual disease assessment in multiple myeloma[J]. Lancet Oncol, 2016, 17(8): e328-e346.
[13] 沈元元,张青,陶千山,等.淀粉样变性患者临床特征、治疗效果及预后[J]. 临床军医杂志,2021,49(7):757-759.
Shen YY, Zhang Q, Tao QS, et al.Clinical features, therapeutic effects and prognosis of patients with amyloidosis[J]. Clinical Journal of Medical Officers, 2021, 49(7):757-759.
[14] Huang X, Wang Q, Chen W, et al.Induction therapy with bortezomib and dexamethasone followed by autologous stem cell transplantation versus autologous stem cell transplantation alone in the treatment of renal AL amyloidosis: a randomized controlled trial[J]. BMC Med, 2014, 12: 2-11.
[15] Huang X, Ren G, Chen W, et al.The role of induction therapy before autologous stem cell transplantation in low disease burden AL amyloidosis patients[J]. Amyloid, 2021, 28(2): 75-83.
[16] 中华医学会血液学分会浆细胞疾病学组, 中国医师协会多发性骨髓瘤专业委员会.中国多发性骨髓瘤自体造血干细胞移植指南(2021 年版)[J].中华血液学杂志, 2021, 42(5): 353-357.
Plasma Cell Disease Group,Chinese Society of Hematology;Chinese Medical Association,Chinese Myeloma Committee-Chinese Hematology Association. Chinese guidelines of autologous stem cell transplantation for multiple myeloma(2021)[J]. Chinese Journal of Hematology, 2021, 42(5): 353-357.