Skeletal Myopathy as the Initial Manifestation of Light Chain Multiple Myeloma

  • Mohamed Reda Belkhribchia Department of Neurology, Hassan II Regional Hospital, Dakhla, Morocco
  • Sara Moukhlis Pathologic Anatomy and Cytology Laboratory, University Hospital Center Ibn Rochd, Casablanca, Morocco
  • Tarik Bentaoune Department of Cardiology, Hassan II Regional Hospital, Dakhla, Morocco
  • Najat Chourkani Private Neurology Practice, Casablanca, Morocco
  • Mohamed Zaidani Department of Hematology, Ryad Oncologia Clinic, Casablanca, Morocco
  • Mehdi Karkouri Pathologic Anatomy and Cytology Laboratory, University Hospital Center Ibn Rochd, Casablanca, Morocco

Keywords

Light chain deposition disease, skeletal myopathy, light chain multiple myeloma, monoclonal immunoglobulin deposition disease, chemotherapy

Abstract

Monoclonal gammopathies due to plasma cell dyscrasias can cause various rare neuromuscular disorders. The peripheral nervous system is most commonly affected, while muscle diseases associated with monoclonal gammopathies are rare. Skeletal myopathy, as a manifestation in the context of multiple myeloma, is extremely uncommon and is usually the result of immunoglobulin light chain (AL) amyloidosis deposits in the muscles. Here we present an atypical case of a patient with generalized myopathy as the presenting manifestation of light chain multiple myeloma. Interestingly, muscle involvement in our case was not the consequence of AL amyloidosis deposits but rather due to non-amyloid light chain deposition disease associated with light chain multiple myeloma.

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References

Rafae A, Malik MN, Abu Zar M, Durer S, Durer C. An overview of light chain multiple myeloma: clinical characteristics and rarities, management strategies, and disease monitoring. Cureus 2018;10(8):e3148.

Yata T, Miwa T, Araki K, Kida T, Toyooka K, Nishino I, et al. A case of systemic AL amyloidosis diagnosed on muscle biopsy. Rinsho Shinkeigaku 2020;60(1):60–63.

Malek N, O'Donovan DG, Manji H. AL amyloidosis presenting with limb girdle myopathy. Pract Neurol 2018;18(6):497–500.

Jimenez-Zepeda VH. Light chain deposition disease: novel biological insights and treatment advances. Int J Lab Hematol 2012;34:347–355.

Buxbaum J, Gallo G. Nonamyloidotic monoclonal immunoglobulin deposition disease: light-chain, heavy-chain, and light- and heavy-chain deposition diseases. Hematol Oncol Clin North Am 1999;13:1235–1248.

Kasahara N, Tamura H, Matsumura O, Nagasawa R, Suzuki Y, Ohgida T, et al. An autopsy case of light chain deposition disease. Intern Med 1994;33(4):216–221.

Ostrow LW, Corse AM, Morrison BM, Huff CA, Carrino JA, Hoke A, et al. Expanding the spectrum of monoclonal light chain deposition disease in muscle. Muscle Nerve 2012;45(5):755–761.

Venner CP, Lane T, Foard D, Rannigan L, Gibbs SD, Pinney JH, et al. Cyclophosphamide, bortezomib, and dexamethasone therapy in AL amyloidosis is associated with high clonal response rates and prolonged progression-free survival. Blood 2012;119:4387–4390.

Published: 2020-11-20

Issue: LATEST ONLINE (view)

Section: Articles

How to cite:
1.
Belkhribchia MR, Moukhlis S, Bentaoune T, Chourkani N, Zaidani M, Karkouri M. Skeletal Myopathy as the Initial Manifestation of Light Chain Multiple Myeloma. EJCRIM 2020;2 doi:10.12890/2020_002095.