Amyloid arthropathy in smoldering myeloma: Do not take it lightly. (2021)

• Record Type: Journal Article
• Authors: Muchtar, Eli; King, Rebecca L.; McPhail, Ellen D.; Thorpe, Matthew P.; Gonsalves, Wilson; Ernste, Floranne; Grogan, Martha; Dispenzieri, Angela; Gertz, Morie A.
• Is Part Of: Leukemia research reports. Volume 15(2021)
• Publication Date: 2021
• Subjects: Amyloidosis -- Arthropathic -- Arthrocentesis -- Congo red; Leukemia -- Periodicals; Lymphomas -- Periodicals; Multiple myeloma -- Periodicals; Leukemia -- Periodicals; Lymphoma -- Periodicals; Multiple Myeloma -- Periodicals; Hematologic Neoplasms -- Periodicals; Leukemia; Lymphomas; Multiple myeloma; Electronic journals; Periodicals; 616.9941905
• DOI: 10.1016/j.lrr.2021.100242
• Languages: English
• ISSNs: 2213-0489

Abstract

Abstract: We report a case of smoldering multiple myeloma patient who developed signs and symptoms consistent with polyarthritis. A PET-CT demonstrated marked FDG activity in multiple joints, concerning for inflammatory arthritis. Arthrocentesis from the glenohumeral joint was consistent with inflammatory synovial fluid with no evidence for infection or crystals. Congo-red stain of the synovial fluid was positive, and mass-spectrometry based amyloid typing was consistent with wild-type transthyretin type. The patient responded instantly to glucocorticoids. This case reports highlights the feasibility of non-tissue diagnosis of amyloidosis using body fluids and underscores the importance of accurate typing to avoid erroneous treatment