Rare Case of Multiple Myeloma and Echinococcus Granulosus Infection
Posted: Monday, April 26, 2021
Isoelectric focusing electrophoresis is considered the standard of care for detecting oligoclonal bands in cerebrospinal fluid; however, no previous report has used this method to identify type III oligoclonal bands. A study published in Medicine reported a rare case of a patient diagnosed with concurrent multiple myeloma and Echinococcus granulosus infection through isoelectric focusing electrophoresis.
“Isoelectric focusing electrophoresis of cerebrospinal fluid may be an auxiliary diagnostic method for multiple myeloma in the future,” concluded Yuming Xu, MD, PhD, of The First Affiliated Hospital of Zhengzhou University, and colleagues.
A 71-year-old man presented with weakness of the right lower extremity accompanied by fever for more than 6 months. The research team performed electrophoresis to identify oligoclonal bands. Next-generation sequencing was used to detect E granulosus infection. The patient was subsequently tested with a bone marrow smear, bone marrow biopsy, and immunohistochemical analysis, which strongly suggested multiple myeloma.
During electrophoresis, the oligoclonal bands were identified as type III and exhibited unique characteristics. The pattern indicated a particular pathogen infection, identified using next-generation sequencing. The bone marrow biopsy revealed atypical plasma cells, indicating multiple myeloma. Multiple myeloma and parasitic infection are clinically unrelated, the authors emphasized. Patients will rarely have both, emphasizing the potential for misdiagnosis.
The researchers treated the fever with cefminox sodium and biapenem, and the deworming process lasted about a month. The patient received chemotherapy, immunoregulation, and other treatments for myeloma. During 15 months of follow-up, the patient’s vital signs stabilized, and his temperature returned to normal. No significant changes were observed in the MRI of the head.
Disclosure: The study authors reported no conflicts of interest.