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Stridor: unusual presentation of multiple myeloma

Published online by Cambridge University Press:  08 March 2006

David Sinclair
Affiliation:
Department of Clinical Biochemistry, Queen Alexandra Hospital, Portsmouth, UK.
Adel Resouly
Affiliation:
Department of Clinical Biochemistry, Head and Neck Unit, Queen Alexandra Hospital, Portsmouth, UK.
Anne Spedding
Affiliation:
Department of Histopathology, Queen Alexandra Hospital, Portsmouth, UK.

Abstract

We present a patient with multiple myeloma whose only presenting symptom was stridor caused by a subglottic stenosis. Biopsy suggested the presence of amyloid which prompted immunological investigations that showed hypogammaglobulinaemia and the presence of Bence Jones proteinuria at 0.93 g/24 hours. Further investigation demonstrated a 15 per cent plasma cell infiltrate into the bone marrow and a lytic lesion in the mid-shaft of the right femur. Chemotherapy and localized radiotherapy were commenced. This is a most unusual presentation of multiple myeloma and shows that immunoglobulin profiles should be properly investigated in such cases.

Type
Other
Copyright
© Royal Society of Medicine Press Limited 2003

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