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Multiple Myeloma, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Normal cells transform into myeloma cells at the hematopoietic stem cell level.

  • Pathologic derangements:

    • Tumor cells within marrow lead to bone destruction and cytopenia.

    • Immunodeficien...

Diagnosis

Signs and Symptoms

  • Bone pain predominates (with secondary disuse or neurologic sequelae):

    • Ribs/sternum

    • Spine

    • Clavicle

    • Skull

    • Shoulder

    • Hip

  • Constitutional symptoms:

    • Anemia

    • Weakness

    • Fatigue

    • Recurrent infect...

Treatment

Pre-Hospital

Immobilize appropriately patients with MM who present with back pain or neurologic symptoms: 
  • Presume to have a pathologic spinal fracture

Initial Stabilization/Therapy

Recognition ...

Follow-Up

Disposition

Admission Criteria

  • Refractory pain requiring systemic analgesics

  • Life-threatening complications of MM, including acute renal failure, hypercalcemia, sepsis, spinal cord compression,...

Pearls and Pitfalls

  • Infectious complications are the major cause of morbidity and mortality such that febrile illness should be treated with empiric therapy for common respiratory and urinary tract in...

Additional Reading

  • Altundag  K, Altundag  O, Gundeslioglu  O. Multiple myeloma. N Engl J Med.  2005;352:840–841.

  • Bladé  J, Rosiñol  L. Complications of multiple myeloma. Hematol Oncol Clin North A...

Codes

ICD9

203.00 Multiple myeloma, without mention of having achieved remission 

ICD10

C90.00 Multiple myeloma not having achieved remission 

SNOMED

  • 109989006 multiple myeloma (disorder)

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