MM clinical spectrum

Q: 66 year old male with multiple myeloma (MM) is admitted to ICU with mental status change. Which of the following is more common in patients with MM? (select one)

A) Anemia 
B) Hypercalcemia


Answer: A

The objective of the above question is to emphasize that though hypercalcemia is considered synonymous with MM, there are other abnormalities that may be more common. One of the largest retrospective studies looking into the clinical spectrum of MM was done at Mayo in 2003 counting more than 1000 patients. It found the following frequency

• Anemia - 73 percent 
• Bone pain - 58 percent 
• Elevated creatinine - 48 percent 
• Fatigue/generalized weakness  - 32 percent 
• Hypercalcemia -28 percent
• Weight loss - 24 percent
• Paresthesias - 5 percent
• Hepatomegaly - 4 percent
• Splenomegaly  - 1 percent
• Lymphadenopathy - 1 percent, and 
• Fever - 0.7 percent

#hematology

#electrolytes

Reference:

Kyle RA, Gertz MA, Witzig TE, et al. Review of 1027 patients with newly diagnosed multiple myeloma. Mayo Clin Proc 2003; 78:21.