Myeloma Causes and Symptoms
The cause of myeloma is unknown. Several factors have been linked to myeloma, including genetic abnormalities, exposures to certain chemicals and other conditions in the workplace (petrochemical industry workers, leather workers, book binders, cosmetologists, shipyard workers, metallurgic industry workers), exposure to very large doses of radiation, certain viral infections, and immune system dysfunction. However, how any of these factors actually causes myeloma is unknown. Some people who develop myeloma have none of these risk factors.
The symptoms of myeloma depend upon the extent of plasma cell disease and the specific properties of the M proteins secreted.
- Unexpected early osteoporosis can be a sign of myeloma. A person considered too young to be "hunched over" or who notices progressive loss of height or alteration in spinal curvature may have myeloma in the vertebral bones.
- Osteolytic bone lesions: The most common symptom is pain. The most frequently affected areas of the skeleton are the ribs and the spine, resulting in chest wall or back pain. In more advanced myeloma, bone degeneration can cause bones to press on nerve structures, resulting in tingling, numbness, burning sensation, loss of function of a limb or joint, or even paralysis.
- Hypercalcemia and kidney damage: Common symptoms include fatigue, nausea, vomiting, loss of appetite, muscle weakness, constipation, decreased urine production, dehydration and increased thirst, restlessness, difficulty in thinking or concentrating, and confusion. Patients without hypercalcemia but with kidney damage may have no symptoms or may complain of foamy urine.
- Hyperviscosity syndrome: Symptoms associated with sludging in the blood vessels may include spontaneous bruising or bleeding (from the mouth, nose, or internally), visual problems (due to bleeding and vascular problems in the eye [retinopathy]), neurologic problems (lethargy, confusion, sleepiness, headache, problems with sensation or movement in one area of the body [neuropathy], stroke), and shortness of breath or chest pain (due to congestive heart failure caused by an increased blood volume meant to dilute the blood).
- Low red blood cell count (anemia): Symptoms include fatigue, paleness, and mild shortness of breath.
- Low white blood cell count: Symptoms include increased frequency of and susceptibility to infections.
- Low platelet count: Symptoms include spontaneous bruising, bleeding, or tiny red spots on the skin caused by slowed or unproductive blood clotting. Bleeding can also be internal. Undetected bleeding may occur in the brain or digestive tract.
- Cryoglobulinemia: The usual symptoms are increased sensitivity to cold and/or pain and numbness in the fingers and toes during cold weather.
- Amyloidosis: The symptoms are related to malfunction or failure of organs or structures infiltrated by amyloid deposits. These symptoms include problems such as heart failure, liver failure, kidney failure, and blood vessel damage.
Clarence Sarkodee-Adoo, MD
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