Decreased production of normal immunoglobulins leads to increased susceptibility to bacterial infections. The most common infections include pneumonias and pyelonephritis.
Bone pain, especially back pain, is a common symptom of multiple myeloma as the spine loses calcium.
Bone disease in multiple myeloma is due to the overexpression of RANKL in bone marrow stroma which activates osteoclasts causing bone resorption. This can result in lytic bone lesions that appear as punched out radiolucencies on plain radiographs.
Bone disease in multiple myeloma is due to the overexpression of RANKL in bone marrow stroma which activates osteoclasts causing bone resorption. This can result in lytic bone lesions that appear as punched out lesions in plain radiographs. Excess bone resorption also leads to release of calcium into blood causing hypercalcemia.
A common complication of multiple myeloma is immunoglobulin light chain (AL) amyloidosis, also known as primary amyloidosis. This occurs when plasma cells produce light chains (fragments of immunoglobulins) that accumulate and deposit in various tissues e.g. heart, kidneys, and the gastrointestinal tract.
The cause of renal insufficiency in multiple myeloma is multifactorial. Etiologies include light chain deposition, hypercalcemia, amyloidosis, analgesic nephropathy from chronic NSAID use for bone pain, and myeloma cast nephropathy, which may cause the presence of light chains in the urine known as Bence Jones proteinuria.
Multiple myeloma normally causes a normocytic normochromic anemia due to replacement of normal bone marrow by infiltrating tumor cells. Inhibition of normal red blood cell production by cytokines also contributes.
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