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Diagnosed multiple myeloma. Scheduled for decompression of spinal fracture. Osteolytic lesion seen. Has hypercalcima. Treatment process?

JK is 60 years of age and is a male patient who is admitted with the diagnosis of multiple myeloma . He presents with a spinal fracture of the fifth lumbar vertebrae . The patient is scheduled for a decompression of the spinal fracture. The patient is to remain on bed rest and should be log rolled. Osteolytic lesions are seen in x-rays of the skull , vertebrae, and ribs. The patient has hypercalcemia. What could be going on with this patient?
Asked On : Tue, 26 Mar 2013
Answers:  2 Views:  58
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Orthopaedic Surgeon, Joint Replacement 's  Response
Jul 2013
Hi, thanks for writing to HCM.

Most of the patients with multiple myeloma remain asymptomatic untill the time they present with some sort of PATHOLOGICAL FRACTURE (as in this case with a vertebral fracture).

* The primary treatment is by CHEMOTHERAPY.

* Localised radiation therapy is useful for solitary lesions

* Supportive care includes early treatment of infections; control of hypercalcemia with glucocorticoids, hydration and administration of bisphosphonates to antagonize skeletal destruction.

* Autologous stem cell transplantation and bone marrow transplantation are the other options.

Hope this information is helpful. Good day
Answered: Sun, 21 Jul 2013
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Internal Medicine Specialist Dr. Sumanth K P's  Response
hello in multiple myeloma osteolytic lesions cause hypercalcaemia due to mobilization of calcium from bone due to activation of osteoclast activating factors. Osteoclast activating factors are produced by tumour cells of myeloma. Hypercalcaemia may cause nausea and vomiting, renal failure etc. I will advise you to consult haematologist and take his opinion. No need to worry, you will get well soon.
Answered: Sun, 21 Jul 2013
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