Chest
Volume 105, Issue 2, February 1994, Pages 622-624
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Selected Reports
Pleural Effusion in Multiple Myeloma

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We report the first case of IgA-κ multiple myeloma presenting as a myelomatous and eosinophilic pleural effusion with increased adenosine deaminase activity. In a review of the literature, 80 percent of myelomatous pleural effusions are due to IgA multiple myeloma.

Section snippets

Case Report

A 51-year-old man was an alcohol abuser (more than 100 g of alcohol per day) and heavy smoker (2 packs per day). One week before hospital admission, he presented with dyspnea and right-lower chest pain aggravated by coughing and breathing. Physical examination showed only decreased breath sounds in the right base. Laboratory results revealed the following: urea 64 mg/dl (10.6 mmol/L); creatinine, 1.34 mg/dl (118 νm?l/L); serum proteins, 8.9 g/dl (89 g/L); calcium, 12 mg/dl (3 mmol/L); and uric

Discussion

Pleural effusions in MM occur in about 6 percent of patients1 and are due to several etiologies requiring different types of therapy. These etiologies are, most commonly, heart failure secondary to amyloidosis, followed by the following: pulmonary embolism; chronic renal failure; second neoplasm; and pleural myelomatous involvement1, 5, 6 (from adjacent skeletal or parenchymal tumors, direct implantation of tumor nodules on the pleura, and mediastinal lymph node infiltration with lymphatic

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