Rodríguez-Nava MÁ, Soto-Rivas I, Hernández-Meraz O

Language: Spanish
References: 8
Page: 318-323
PDF size: 811.84 Kb.

ABSTRACT

The multiple myeloma is a neoplastic disease characterized by the malignant proliferation of plasma cells with frequent infiltration to the bone marrow and other tissues. Cord compression syndrome (defined by thoracic or lumbar pain), changes in strength or sensation, and sphincter disorders are among the early manifestations. It is crucial that clinicians are aware of this possible diagnosis, not only because its omission delays diagnosis, as in the case reported in this paper, but also the correct treatment. Wrong treatments often contribute to increase patient morbidity. When the multiple myeloma presents acute and aggressive behavior it is imperative not to delay the diagnosis. Cord compression syndrome may begin with symmetrical paresthesias of the lower limbs that evolve to paraplegia gradually ascending as infiltration, tumor expansion, and growth of spinal metastases invade the epidural space and the spinal canal. All these clinical manifestations can make the clinician think of a Guillain Barre Syndrome. Misinterpretation of electromyography ends up hindering the proper diagnosis and treatment. In Mexico, intravenous immunoglobulin is used for the treatment of Guillain- Barre syndrome. In a patient with multiple myeloma this would further increase blood viscosity, with subsequent deterioration of renal and cardiac functions.

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