Multiple myeloma history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:  Hannan Javed, M.D.[2]; Haytham Allaham, M.D. [3]; Shyam Patel [4]

## Overview

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The history and symptoms of multiple myeloma are based on the underlying effect of excess plasma cells on various organ systems. Pain is usually a symptom of newly diagnosed multiple myeloma. Broad categories of symptoms include bone-related symptoms, neurological symptoms, hypercalcemia-related symptoms, bone marrow failure-related symptoms, and thrombosis-related symptoms. Although all of these symptoms are possible, the presentation of multiple myeloma varies from patient to patient.

## History and Symptoms

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Relevant history includes:

* Review of past medical history for other plasma cell diseases, hematologic malignancies, underlying renal disease, and underlying bone disease
* Review of family history for members with positive history of hematologic malignancies
* Review of occupational history related to farming, oil industry, or Agent Orange exposure

History includes character, location, onset, and duration of pain (typically bony pain). Symptoms of multiple myeloma include:[1][2][3][4][5][6]

* Bone pain

* Usually involves the spine and ribs (axial skeleton), and worsens with activity
* Persistent localized pain may indicate a pathological bone fracture
* Inability to carry out routine tasks due to limitation by pain

* Neurological symptoms

* Numbness due to plasma cell infiltration of nerves or anti-neuronal glycoprotein antibodies
* Muscle weakness
* Confusion
* Dizziness
* Headache
* Paralysis
* Visual changes

* Hypercalcemia-related symptoms

* Polyuria
* Polydipsia
* Constipation
* Loss of appetite
* Nausea and vomiting
* Lethargy due to anemia

* Bone marrow failure-related symptoms: This is due to crowding out of normal bone marrow precursors by malignant plasma cells.

* Easy bruising, nosebleeds, bleeding gums due to thrombocytopenia
* Fatigue, weakness, shortness of breath, dizziness and paleness due to anemia
* Recurrent infections due to leukopenia

* Lower limb edema due to renal involvement

* Thrombotic symptoms: Thrombosis is more common in multiple myeloma due to cancer-associated thrombosis and due to lenalidomide, which increases thrombotic risk.

* Shortness of breath due to pulmonary embolism
* Lower extremity edema due to deep vein thrombosis
* Abdominal pain due to mesenteric venous thrombosis
* Transient ischemic attack
* Retinal hemorrhage

## References

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1. ↑ Multiple myeloma. Wikipedia (2015) https://en.wikipedia.org/wiki/Multiple_myeloma#Signs_and_symptoms Accessed on September, 20th 2015
2. ↑ Multiple myeloma. Canadian Cancer Society (2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/signs-and-symptoms/?region=mb Accessed on September 20th 2015
3. ↑ Multiple myeloma. Cancer. gov(2015) http://www.cancer.gov/types/myeloma Accessed on September, 20th 2015
4. ↑ Reisenbuckler C (2014). "Multiple myeloma and diagnostic imaging". Radiol Technol. 85 (4): 391–410, quiz 411–3. PMID 24614435.
5. ↑ Sergentanis TN, Zagouri F, Tsilimidos G, Tsagianni A, Tseliou M, Dimopoulos MA, Psaltopoulou T (October 2015). "Risk Factors for Multiple Myeloma: A Systematic Review of Meta-Analyses". Clin Lymphoma Myeloma Leuk. 15 (10): 563–77.e1–3. doi:10.1016/j.clml.2015.06.003. PMID 26294217.
6. ↑ Eslick R, Talaulikar D (October 2013). "Multiple myeloma: from diagnosis to treatment". Aust Fam Physician. 42 (10): 684–8. PMID 24130968.