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Case Reports
. 2009 Apr 28;15(16):2038-40.
doi: 10.3748/wjg.15.2038.

Hepatic failure caused by plasma cell infiltration in multiple myeloma

Fadi-E Rahhal  1 , Robert-R Schade, Asha Nayak, Teresa A Coleman
Affiliations
Case Reports

Hepatic failure caused by plasma cell infiltration in multiple myeloma

Fadi-E Rahhal et al. World J Gastroenterol. .

Abstract

Although plasma cell infiltration is not rare in autopsy of patients with multiple myeloma (MM), it is very rarely detected in living patients. This is because MM rarely causes significant liver dysfunction that requires further evaluation. A 49-year-old man presented with acute renal failure and was diagnosed with kappa light chain MM stage IIB. Thalidomide and dexamethasone were initiated. The patient developed a continuous increase in bilirubin that led to severe cholestasis. A liver biopsy revealed plasma cell infiltration. He then rapidly progressed to liver failure and died. Treatment options are limited in MM with significant liver dysfunction. Despite new drug therapies in MM, those patients with rapidly progressive liver failure appear to have a dismal outcome.

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Figures

Figure 1
Figure 1
HE liver biopsy showing massive plasma cell infiltration (HE).
Figure 2
Figure 2
Positive kappa light chain stain on liver biopsy.
Figure 3
Figure 3
Positive CD138 (syndecan-1), a plasma cell marker. CD138 is expressed on plasma cells, including the malignant plasma cells of MM and some lymphomas.
See this image and copyright information in PMC

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