Non-traumatic splenic rupture in amyloidosis as a rare evolution of multiple myeloma

  • Lorenzo Perrone Department of Oncology, Maugeri Clinical and Scientific Institutes (IRCCS), Pavia; Department of Internal Medicine, University of Pavia, Pavia, Italy.
  • Lorenzo Gervaso Department of Oncology, Maugeri Clinical and Scientific Institutes (IRCCS), Pavia; Department of Internal Medicine, University of Pavia, Pavia, Italy.
  • Eugenia Bosco Department of Oncology, Maugeri Clinical and Scientific Institutes (IRCCS), Pavia; Department of Internal Medicine, University of Pavia, Pavia, Italy.
  • Francesco Serra Department of Oncology, Maugeri Clinical and Scientific Institutes (IRCCS), Pavia; Department of Internal Medicine, University of Pavia, Pavia, Italy.
  • Erica Quaquarini | erica.quaquarini@icsmaugeri.it Department of Oncology, Maugeri Clinical and Scientific Institutes (IRCCS), Pavia; PhD Program in Experimental Medicine, University of Pavia, Pavia, Italy.

Abstract

We report the case of a 64-year-old man with a diagnosis of IgG lambda multiple myeloma (MM) symptomatic for bone lesions for which he received autologous stem cell transplant after induction treatment and high-dose melphalan, thalidomide and lenalidomide therapy. Twelve years after the diagnosis, he had an unexpected and acute onset of abdominal pain with signs of hypovolemic shock. A computed tomography scan was immediately performed and demonstrated a splenic rupture. A splenectomy was performed but, a week after, the patient developed an acute respiratory distress syndrome and died. After histological exam of the spleen, non-traumatic spleen rupture due to amyloidosis was our final diagnosis. This event is potentially fatal and rare in patients with MM; clinicians should be aware of this potential course of the disease and monitor patients also for amyloid induced organ damages.

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Published
2019-05-07
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Section
Case Reports
Keywords:
Splenic rupture, Amyloid light chain amyloidosis, Multiple myeloma
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How to Cite
Perrone, L., Gervaso, L., Bosco, E., Serra, F., & Quaquarini, E. (2019). Non-traumatic splenic rupture in amyloidosis as a rare evolution of multiple myeloma. Clinics and Practice, 9(2). https://doi.org/10.4081/cp.2019.1146