Sensorineural Hearing Loss as a First Presentation of Multiple Myeloma: A Successful Management with Therapeutic Plasma Exchange
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Abstract
Sudden sensorineural hearing loss (SSNHL) as the initial manifestation of multiple myeloma (MM) is rare. We present a 45-year-old woman with hyperviscosity syndrome (serum viscosity of 10.2 cP) from MM who presented with hearing disturbance that responded dramatically to plasma exchange with saline and intratympanic steroid
treatment. Serum protein electrophoresis confirmed the presence of a monoclonal band, and bone marrow biopsy showed a hypercellular marrow with 90% plasma cells, which demonstrated lambda monoclonal restriction.
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[7] Liamis G, Liberopoulos E, Barkas F, Elisaf M. Spurious electrolyte disorders: a diagnostic challenge for clinicians. Am J Nephrol. 2013;38(1):50-7. https://doi.org/10.1159/000351804
[8] Hillier TA, Abbott RD, Barrett EJ. Hyponatremia: evaluating the correction factor for hyperglycemia. Am J Med.
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[9] Pandey S, Post S, Alapat D, Smock K, Post GJ. Prolonged prothrombin time correlates with serum monoclonal protein concentration in patients with plasma cell dyscrasia. Int J Lab Hematol. 2013;35(4):421-7. https://doi.org/10.1111/ijlh.12036
[10] Huang H, Li H, Li D. Effect of serum monoclonal protein concentration on haemostasis in patients with multiple myeloma. Blood Coagul Fibrinolysis. 2015;26(5):555-9. https://doi. org/10.1097/MBC.0000000000000296
[11] Gupta N, Setia R, Mittal A, Choudhary D, Kapoor RK, Dadu T, et al. Interference with Laboratory Test Results Due to Multiple Myeloma Related Hypergammaglobulinemia: An Illustrative Case Report. Int J Lab Hematol. 2019;2(3):114-9.
[2] Rajkumar SV. Multiple myeloma: 2022 update on diagnosis, risk stratification, and management. Am J Hematol.
2022;97(8):1086-107. https://doi.org/10.1002/ajh.26590
[3] Lee EJ, Yoon YJ. Bilateral sudden sensorineural hearing loss as an initial presentation of myelodysplastic syndrome. Am J Otolaryngol. 2012;33(6):782-3. https://doi.org/10.1016/j.amjoto.2012.08.003
[4] Chae SW, Cho JH, Lee JH, Kang HJ, Hwang SJ. Sudden hearing loss in chronic myelogenous leukaemia implicating the hyperviscosity syndrome. J Laryngol Otol. 2002;116(4):291-3. https://doi.org/10.1258/0022215021910564
[5] Gertz MA. Acute hyperviscosity: syndromes and management. Blood. 2018;132(13):1379-85. https://doi.org/10.1182/
blood-2018-06-846816
[6] Nguyen A, Wahed A. Sources of errors in coagulation testing. In: Accurate Results in the Clinical Laboratory. Elsevier;
2019. p. 395-9. https://doi.org/10.1016/B978-0-12-813776- 5.00026-1
[7] Liamis G, Liberopoulos E, Barkas F, Elisaf M. Spurious electrolyte disorders: a diagnostic challenge for clinicians. Am J Nephrol. 2013;38(1):50-7. https://doi.org/10.1159/000351804
[8] Hillier TA, Abbott RD, Barrett EJ. Hyponatremia: evaluating the correction factor for hyperglycemia. Am J Med.
1999;106(4):399-403. https://doi.org/10.1016/S0002- 9343(99)00055-8
[9] Pandey S, Post S, Alapat D, Smock K, Post GJ. Prolonged prothrombin time correlates with serum monoclonal protein concentration in patients with plasma cell dyscrasia. Int J Lab Hematol. 2013;35(4):421-7. https://doi.org/10.1111/ijlh.12036
[10] Huang H, Li H, Li D. Effect of serum monoclonal protein concentration on haemostasis in patients with multiple myeloma. Blood Coagul Fibrinolysis. 2015;26(5):555-9. https://doi. org/10.1097/MBC.0000000000000296
[11] Gupta N, Setia R, Mittal A, Choudhary D, Kapoor RK, Dadu T, et al. Interference with Laboratory Test Results Due to Multiple Myeloma Related Hypergammaglobulinemia: An Illustrative Case Report. Int J Lab Hematol. 2019;2(3):114-9.
| Files | ||
| Issue | Vol 9 No 3 (2024): May-June | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/crcp.v9i3.17239 | |
| Keywords | ||
| Sensorineural hearing Loss Viscosity Multiple myeloma Plasma exchange | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Daraei M, Khajeh-Mehrizi A, Amirzargar B, Ameli F, Zeinalkhan F. Sensorineural Hearing Loss as a First Presentation of Multiple Myeloma: A Successful Management with Therapeutic Plasma Exchange. CRCP. 2024;9(3):125-132.
