Patel Tanvi H, Bachu Ramya, Davis Ben, Damalcheruvu Prashanth, Thanendrarajan Sharmilan
Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, USA.
Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, USA.
Cureus. 2023 Jul 2;15(7):e41292. doi: 10.7759/cureus.41292. eCollection 2023 Jul.
Multiple myeloma (MM) is a clonal plasma cell proliferative disorder characterized by the abnormal increase of monoclonal paraprotein and can lead to specific end-organ damage. Necrotizing enterocolitis or bowel necrosis is a surgical emergency defined by cellular death because of reduced blood flow to the gastrointestinal tract. We report a case of a 75-year-old female who was diagnosed with hyperviscosity syndrome (HVS) and was sent to ED. Further workup showed that she had a new diagnosis of IgG kappa MM for which she was started on chemotherapy. Later, she developed respiratory distress and abdomen distention with less frequent bowel movements, and general surgery was consulted. CT scan of the abdomen and pelvis with contrast showed findings consistent with bowel ischemia vs infarction. The patient was immediately taken to the operating room, and exploratory laparotomy showed nonsurvivable bowel necrosis. She was transitioned to comfort care and passed away later. We aim to increase awareness among physicians to include HVS as one of the possible complications of MM and to detect it early to prevent morbidity and mortality.
多发性骨髓瘤（MM）是一种克隆性浆细胞增殖性疾病，其特征为单克隆副蛋白异常增加，并可导致特定的终末器官损害。坏死性小肠结肠炎或肠坏死是一种外科急症，定义为因胃肠道血流减少导致的细胞死亡。我们报告一例75岁女性患者，被诊断为高黏滞血症（HVS）并被送往急诊科。进一步检查显示她新诊断为IgG κ型MM，为此开始接受化疗。后来，她出现呼吸窘迫和腹胀，排便次数减少，遂咨询普通外科。腹部和盆腔增强CT扫描结果显示与肠缺血或梗死相符。患者立即被送往手术室，剖腹探查显示肠坏死无法挽救。她被转为舒适护理，随后去世。我们旨在提高医生的认识，将HVS列为MM可能的并发症之一，并尽早发现以预防发病和死亡。
