Korean J Med.  2000 Jun;58(6):686-691.

A case of multiple myeloma with ascites

• Song DS
• Han JY
• Kwen HJ
• Min KO
• Lee SS
• Kim HS
• Seo EJ
• Lee KS
• Kim MH
• Lee EH

Abstract

Ascites is a rare complication of multiple myeloma. When it develops, it is usually associated with extensive liver infiltration with plasma cells, infectious peritonitis or myelomatous peritoneal infiltration. Ascites caused by peritoneal infiltration is even less frequent than others. The majority of previously reported cases were characterized by an IgA paraprotein and lack of skeletal lesions. This rare extramedullary complication of myeloma has been unresponsive to therapy and rapidly fatal. Therefore, it is important to recognize myeloma as a cause of ascites and the presence of ascites heralds a poor prognosis of myeloma. We recently experienced a case of myeloma with ascites and reviewed the relevant literature of human myeloma presenting with the triad of ascites, relative or absolute sparing of the skeleton, and an IgA paraprotein. A 76-year-old man was presented with ascites early in the course of myeloma. He had no evidence of intra-abdominal plasmacytoma and skeletal lesions. Myelomatous ascites was demonstrated by the monoclonal immunoglobulin of IgA type in ascitic fluid. He was treated by plasmapheresis due to hyperviscosity syndrome and VAD combination chemotherapy. He was discharged with the improved clinical condition.

Keyword

Multiple myeloma; Ascites; IgA; Paraproteins

MeSH Terms

Aged
Ascites*
Ascitic Fluid
Drug Therapy, Combination
Humans
Immunoglobulin A
Immunoglobulins
Liver
Multiple Myeloma*
Paraproteins
Peritonitis
Plasma Cells
Plasmacytoma
Plasmapheresis
Prognosis
Skeleton
Immunoglobulin A
Immunoglobulins
Paraproteins