Muchtar E, King RL, McPhail ED, Thorpe MP, Gonsalves W, Ernste F, Grogan M, Dispenzieri A, Gertz MA. Amyloid arthropathy in smoldering myeloma: Do not take it lightly.
Leuk Res Rep 2021;
15:100242. [PMID:
33996437 PMCID:
PMC8105656 DOI:
10.1016/j.lrr.2021.100242]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 04/09/2021] [Accepted: 04/21/2021] [Indexed: 12/01/2022] Open
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
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