Vnitr Lek 2016, 62(2):114-124

The patient complains of spinal pain or fatigue and weakness. How do I recognize whether their cause is spondylarthrosis, the patient's age or multiple myeloma?

Zdeněk Adam^1,*, Eva Pourová², Luděk Pour¹, Eva Michalková¹, Marta Krejčí¹, Renata Koukalová³, Zdeněk Řehák³, Jiří Vaníček⁴, Tomáš Nebeský⁵, Hana Petrášová⁵, Sabina Ševčíková⁶, Michal Mašek⁷, Zdeněk Král¹, Aleš Čermák⁸

¹ Interní hematologická a onkologická klinika LF MU a FN Brno

² Ordinace praktického lékaře pro dospělé Pustiměř

³ Oddělení nukleární medicíny, centrum PET, RECAMO, Masarykův onkologický ústav Brno

⁴ Klinika zobrazovacích metod LF MU a FN u sv. Anny Brno

⁵ Radiologická klinika LF MU a FN Brno

⁶ Katedra patologické fyziologie LF MU Brno

⁷ Klinika úrazové chirurgie LF MU a FN Brno

⁸ Urologická klinika LF MU a FN Brno

Multiple myeloma has varied manifestations which resemble common patient complaints and that is why this disease is typically not diagnosed until it reaches an advanced stage. Spinal pains can be an expression of deformative and discogenous changes, but also a symptom of multiple myeloma. Pains in the long bones may result from the pain radiating from an arthrotic joint, but also from a large myelomatic osteolytic lesion which makes the bone prone to a spontaneous fracture. Pathological weariness may have many causes, multiple myeloma being one of them. Anemia may have a large number of causes and multiple myeloma is one of them. Raised creatinine levels and renal failure can also be due to many causes and again, multiple myeloma is one of them. Weakened immunity and frequent infections can also have many causes, among them multiple myeloma. Confusion and sleepiness may be due to psychiatric diagnosis, but also may result from hypercalcemia associated with multiple myeloma. The following text which is designed for non-hematology physicians therefore describes in detail the symptoms of multiple myeloma and diagnostic steps leading to establishing the diagnosis and it only briefly outlines the treatment related information. You can also visit www.myeloma.cz for details. This text aims to summarize the symptoms of multiple myeloma for physicians not specializing in hematology in order to facilitate earlier diagnosing of the disease.

Keywords: monoclonal gammapathy of undetermined significance; multiple myeloma; osteolysis; renal failure

Received: July 31, 2015; Accepted: September 21, 2015; Published: February 1, 2016  Show citation