Manifestations of Myeloma

Overview

• MGUS and smouldering myeloma by definition do not manifest clinically. Multiple myeloma presents classically with hypercalcaemia, renal dysfunction, anaemia and lytic bony lesions (denoted by the acronym CRAB); myeloma should be suspected in patients with any of these manifestations without any other clear cause.

• • Manifestations of Multiple Myeloma

  • Classical (CRAB)

  • Calcium - hypercalcaemia
  • Renal failure (multifactorial) - due to cast nephropathy, glomerular light chain deposition, hypercalcaemia, amyloidosis
  • Anaemia - normocytic, normochromic
  • Bone lesions - lytic lesions, due to osteoclastic change

  • Other

  • Hyperviscosity syndrome - due to hypergammaglobulinaemia
  • Amyloidosis - GI, cardiac, hepatic, renal, muscular or nerve infiltration
  • Recurrent infections - due to relative hypogammaglobulinaemia