Multiple myeloma differential diagnosis: Difference between revisions

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Revision as of 02:00, 5 August 2018

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]

Overview

Multiple myeloma must be differentiated from monoclonal gammopathy of undetermined significance (MGUS), isolated plasmacytoma of the bone, and extramedullary plasmacytoma.^[1]

Differentiating Multiple Myeloma from other Diseases

The table below summarizes how to differentiate multiple myeloma from other conditions that cause similar presentation:^[1]


Differential Diagnosis	Causes	Features	Therapy

Multiple myeloma	Chromosomal aberrations or other genetic insults Malignant transformation of plasma cells Clonal plasma cell proliferation	Diffuse bone pain and tenderness with osteolytic lesions Renal failure Hypercalcemia Anemia	Induction chemotherapy with bortezomib, lenalidomide, and dexamethasone Bisphosphonates RANK ligand inhibitors (denosumab) Autologous stem cell transplantation
Osteoporosis	Imbalance between bone resorption and bone formation Preceded by osteopenia Decreased bone mineral density	Acute musculoskletal pain if fracture develop Severe decrease in BMD on dual-energy X-ray absorptiometry (DEXA) test T score less than -2.5 on DEXA scan	Calcium and vitamin D supplementation Bisphosphonates Weight-bearing exercise Teriparatide RANK ligand inhibitors (denosumab)
Osteomalacia	Inadequate mineralization of bone Deficiencies in vitamin D, calcium, or phosphorus Renal tubular acidosis Malabsorption	Diffuse bone pain, fatigue, and fractures Low bone mineral density (BMD) Hypocalcemia	Vitamin D3 supplementation
Scurvy	Vitamin C deficieny Malabsorption Hemodialysis	Gum disease Loose teeth Easy bruising	Vitamin C supplementation Citrus fruits
Osteogenesis imperfecta	Mutations in 'COL1A1 or COL1A2 Impaired type I collagen synthesis	Short stature, scoliosis, and propensity for fractures Blue discoloration of sclera	Bisphosphonates Physical therapy Surgical fixation of brittle bones Genetic counseling for offspring
Homocystinuria	Deficiency of cystathione beta synthase Deficiency of folate, vitamin B12, or vitamin B6	Diffuse bone pain and musculoskeletal symptoms	High-dose vitamin B6 supplementation Betaine supplementation

References

↑ ^1.0 ^1.1 "Myeloma - SEER Stat Fact Sheets". Retrieved 17 February 2014.

Template:WikiDoc Sources

[seer-1] 1.0 ^1.1 "Myeloma - SEER Stat Fact Sheets". Retrieved 17 February 2014.

[1]

@@ Line 52: / Line 52: @@
 *RANK ligand inhibitors (denosumab)
 |-
-| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Idiopathic]] transient osteoporosis of [[Hip (anatomy)|hip]]'''
+| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Osteomalacia]]'''
-| style="padding: 5px 5px; background: #F5F5F5;" |
-* On physical examination, demonstrates acute [[hip]] pain
-* On imaging studies, demonstrates sub-chondoral [[Cortical bone|cortical]] loss and diffuse [[osteopenia]] of the [[femoral]] neck
 | style="padding: 5px 5px; background: #F5F5F5;" |
-* On history, demonstrates mostly involvement of [[pregnant]] women and young men
+*Inadequate mineralization of bone
-* On history, demonstrates to be [[self-limiting]] in 6-8 months
+*Deficiencies in vitamin D, calcium, or phosphorus
-|-
+*Renal tubular acidosis
-| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Osteomalacia]]'''
+*Malabsorption
 | style="padding: 5px 5px; background: #F5F5F5;" |
-* On physical examination, demonstrates diffuse [[bone]] [[pain]], fatigue, and [[fractures]] are the common symptoms
+*Diffuse [[bone]] pain, fatigue, and [[fractures]]
-* On imaging studies, demonstrates low [[Bone mineral density|bone mineral density (BMD)]]
+*Low [[bone mineral density|bone mineral density (BMD)]]
+*[[Hypocalcemia]]
 | style="padding: 5px 5px; background: #F5F5F5;" |
-* On imaging studies, demonstrate the brief [[Bone loss|bone mass loss]] in [[bones]]
+*Vitamin D3 supplementation
 |-
 | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Scurvy]]'''
 | style="padding: 5px 5px; background: #F5F5F5;" |
-* On physical examination, demonstrates [[bone pain]] and frequent [[fractures]] due to brittle [[bone]]
+*Vitamin C deficieny
-* On imaging studies, demonstrates low [[Bone mineral density|bone mineral density (BMD)]]
+*Malabsorption
+*Hemodialysis
 | style="padding: 5px 5px; background: #F5F5F5;" |
-* On physical examination, demonstrates other [[mucosal]] disruption symptoms, such as [[bleeding gums]]
+*Gum disease
-* On imaging studies, demonstrates normal [[Bone mineral density|bone mineral density (BMD)]]
+*Loose teeth
+*Easy bruising
+| style="padding: 5px 5px; background: #F5F5F5;" |
+*Vitamin C supplementation
+*Citrus fruits
 |-
 | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Osteogenesis imperfecta]]'''
 | style="padding: 5px 5px; background: #F5F5F5;" |
-* On physical examination, demonstrates [[Short stature]], [[scoliosis]], and propensity for [[Bone fracture|fractures]]
+*Mutations in '''COL1A1'' or ''COL1A2''
+*Impaired type I collagen synthesis
 | style="padding: 5px 5px; background: #F5F5F5;" |
-* On physical examination, demonstrates [[tooth]] defects, [[Hearing impairment|hearing defects]], and blue [[sclera]]
+*[[Short stature]], [[scoliosis]], and propensity for [[Bone fracture|fractures]]
-* On laboratory studies, demonstrates near normal [[Bone mineral density|bone mineral density (BMD)]]
+*Blue discoloration of sclera
+| style="padding: 5px 5px; background: #F5F5F5;" |
+*Bisphosphonates
+*Physical therapy
+*Surgical fixation of brittle bones
+*Genetic counseling for offspring
 |-
 | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Homocystinuria]]'''
 | style="padding: 5px 5px; background: #F5F5F5;" |
-* On physical examination, demonstrates diffuse [[bone]] [[pain]] and [[musculoskeletal]] symptoms
+*Deficiency of cystathione ''beta'' synthase
+*Deficiency of folate, vitamin B12, or vitamin B6
+| style="padding: 5px 5px; background: #F5F5F5;" |
+*Diffuse [[bone]] [[pain]] and [[musculoskeletal]] symptoms
 | style="padding: 5px 5px; background: #F5F5F5;" |
-* On physical examination, demonstrates [[visual impairment]]
+*High-dose vitamin B6 supplementation
-* On laboratory studies, demonstrates high amounts of [[homocysteine]] in [[urine]]
+*Betaine supplementation
 |}
 |}

Multiple myeloma differential diagnosis: Difference between revisions

Revision as of 02:00, 5 August 2018

Overview

Differentiating Multiple Myeloma from other Diseases

References

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