Multiple myeloma associated with hyperbetaglobulinemia in a cirrhotic patient. Case report

Abstract

Introduction: The multiple myeloma is a hemato-oncological disease of clonal origin, characterized by the abnormal production of plasma cells that produce a progressive replacement of the other hema-topoietic lines in the bone marrow. In 95 % of the cases, the condition showed an increase in the production of defective immunoglobulins, predominantly IgG and IgA detected in serum with monoclonal peak, characterized by progressive deterioration of acute renal function, anemia, cytopenias, acute or chronic bone pain, pathological fractures, and recent endocrine disorders. The present case associated with hepatic cirrhosis. Case presentation: A 49-year-old male patient with headache, abdominal pain, thoracic, manes, dyspnea and signs of ascites with a 3-month disease time, and lumbosacral pain history of 3 years before admission. Auxiliary examinations showed pancytopenia, altered coagulation profile, impaired renal function, albumin-globulin inversion, hyperuricemia, ascites, lytic bone lesions, and monoclonal hypergammapathy of IgA type associated with hyperbetaglobulinemia. The specific exams gave as diagnosis multiple IgA EC IIIB myeloma, plus liver cirrhosis, this case is presented as unusual by elevation of serum proteins in both beta and gamma product of two concomitant pathol-ogies. Conclusion: A patient with two simultaneous diseases, both cases with globulin elevation that could confuse the diagnosis, whos state of immunosuppression improved with the administration of immunoglobulins and the treatment for the base disease.