Multiple myeloma-associated skin light chain amyloidosis: A case of misdiagnosis

Xiao,Li; Lin,Fengxia; Xiao,Rong; Hu,Chun; Deng,Mingyang; Li,Daiqiang; She,Xiaoling; Liu,Fuyou; Sun,Lin

doi:10.3892/ol.2016.4432

June-2016 Volume 11 Issue 6

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June-2016 Volume 11 Issue 6

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Article Open Access

Multiple myeloma-associated skin light chain amyloidosis: A case of misdiagnosis

Authors:
- Li Xiao
- Fengxia Lin
- Rong Xiao
- Chun Hu
- Mingyang Deng
- Daiqiang Li
- Xiaoling She
- Fuyou Liu
- Lin Sun
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Affiliations: Department of Nephrology, Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China, Department of Dermatology, Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China, Department of Hematology, Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China, Department of Pathology, Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China

Copyright: © Xiao et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Pages: 3617-3620
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Published online on: April 13, 2016

https://doi.org/10.3892/ol.2016.4432
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Abstract

The present study reports the case of a 42-year-old male with multiple myeloma (MM)-associated skin light chain amyloidosis who presented with skin purpura as the initial symptom, which was misdiagnosis as Henoch-Schönlein purpura nephritis prior to admission to the Second Xiangya Hospital (Changsha, Hunan, China). The patient presented with purpura, papules petechiae and spontaneous ecchymosis, which was located scattered around the neck, chest and limbs, accompanied by a small amount of bleeding in the conjunctival and oral mucosa, and a swollen tongue. Upon laboratory examination, the serum immunological change showed increased serum immunoglobulin G and λ light chain levels, and a urine Bence Jones protein level of >1 g/24 h. This was accompanied with an abnormal result for immunofixation electrophoresis, and positive staining with Congo red showing apple‑green birefringence in skin biopsy specimens. Thus, the patient was diagnosed with MM-associated skin amyloidosis with the initial symptom of skin purpura. Following treatment with chemotherapy consisting of prednisone and bortezomib, the skin lesions markedly improved. The present study indicates that the presentation of skin purpura in systemic amyloidosis associated with MM may be an important aid in the diagnosis and direct treatment of this disease in the clinic.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Multiple myeloma-associated skin light chain amyloidosis: A case of misdiagnosis

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