Serum Level of Lactate Dehydrogenase is a Useful Clinical Marker to Monitor Progressive Multiple Myeloma Diseases: A Case ReportHava Üsküdar Teke1, Mustafa Başak2, Deniz Teke3, Mehmet Kanbay41Kayseri Education And Research Hospital, Department Of Hematology, Kayseri, Turkey
2Kayseri Education And Research Hospital, Department Of Internal Medicine, Kayseri, Turkey
3Kayseri Education And Research Hospital, Department Of Cardiology, Kayseri, Turkey
4Kayseri Education And Research Hospital, Department Of Nephrology, Kayseri, Turkey
To follow the progression of multiple myeloma (MM) disease, serum lactate dehydrogenase (LDH) levels are as useful markers as beta-2 microglobulin and monoclonal immunoglobulin. With this study, we have presented a case of a patient with a multiple myeloma which was fulminant course, whose LDH levels were normal at the onset of diagnosis increasing as 27 times more than normal as the disease progressed and who showed the development of extramedullary plasmacytomas. The patient, an 80-yearold female, was diagnosed with stage IIIA IgA type multiple myeloma and melphalan-prednisolon (MP) treatment was started. Although the LDH levels were low during the diagnosis and chemotherapy, the LDH levels increased up to 7557 U/L following the progression and occurrence of extramedullary plasmacytomas and the patient died. During the observation of the patient with MM, if the LDH levels are abnormally high, the progression of the disease should be considered after eliminating the other causes. Bone marrow aspiration and biopsy should be examined and the progression or relapse should be shown. On the other hand, the patients with LDH levels are high should be considered to have added plasmacytomas, the whole body should be examined at an early stage before the development of clinical symptoms and early treatment should be started. Keywords: Multiple myeloma, LDH, Prognosis
Progresif Multiple Myeloma Hastalığında Serum Laktat Dehidrogenaz Düzeyi Kullanışlı Bir Klinik Belirteçdir: Bir Olgu SunumuHava Üsküdar Teke1, Mustafa Başak2, Deniz Teke3, Mehmet Kanbay41Kayseri Education And Research Hospital, Department Of Hematology, Kayseri, Turkey
2Kayseri Education And Research Hospital, Department Of Internal Medicine, Kayseri, Turkey
3Kayseri Education And Research Hospital, Department Of Cardiology, Kayseri, Turkey
4Kayseri Education And Research Hospital, Department Of Nephrology, Kayseri, Turkey
Serum laktat dehidrogenaz (LDH) düzeyleri, multiple myeloma (MM) hastalık ativitesinin takibi için beta-2 mikroglobulin ve monoklonal immunglobulin kadar kullanışlı bir markırdır. Bu yazıda tanı aşamasında LDH değerleri normal iken, takibinde LDH seviyeleri normalin 27 katı kadar artan ve ekstramedüller plazmasitom gelişen, fulminan seyirli bir multiple myeloma olgusunu sunduk. Seksen yaşındaki bayan hasta, Evre3A IgA tipi multiple myeloma tanısı konularak MP (melphalan-prednizolon) tedavisi başlanan hasta, tanı dönemi ve kemoterapi süresince LDH düzeyleri düşük seyretmesine rağmen progresyon sonrası ve kliniğe eklenen ekstramedüller plazmasitomlar ile LDH düzeyleri 7557 U/L düzeyine kadar çıkmış ve hasta fatal seyretmiştir. MM’li hastaların takibi sırasında LDH değerlerinde olan anormal yüksekliklerde diğer nedenler ekarte edildikten sonra hastalık progresyonu düşünülmelidir. Kemik iliği ve laboratuvar değerlendirmeleri ile progresyon veya nüks gösterilmelidir. LDH seviyeleri yüksek olan hastalarda ise mutlaka ilave olmuş plazmasitomların varlığı düşünülmeli, klinik bulgular gelişmeden erken dönemde tüm vücut taraması yapılmalı ve erken tedavi başlanmalıdır. Anahtar Kelimeler: Multiple myeloma, LDH, Prognoz
Hava Üsküdar Teke, Mustafa Başak, Deniz Teke, Mehmet Kanbay. Serum Level of Lactate Dehydrogenase is a Useful Clinical Marker to Monitor Progressive Multiple Myeloma Diseases: A Case Report. Turk J Hematol. 2014; 31(1): 84-87
Corresponding Author: Hava Üsküdar Teke, Türkiye |
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