Title: Stroke as an Unorthodox Presentation in Multiple Myeloma

Authors: Dr Ojas Ahuja, Dr Roy Sumeet Swapan, Dr Vaibhav Deorari, Dr Nilesh Jadhao, Dr Joy Dev Mukherji, Dr Mukesh Kumar, Dr Ramnik Garg

 DOI: https://dx.doi.org/10.18535/jmscr/v11i4.16

Abstract

Acute ischemic stroke remains the common complication among patients with cancer. However, studies done to determine the relationship between multiple myeloma and ischemic stroke are limited and the association between them remains unclear till date. 

Here we presented a case of elderly male who presented with recurrent strokes, when investigated extensively, found to have cardiac amyloidosis and blood investigations which raised the suspicion of multiple myeloma, which was proven by the appropriate investigations. 

This case signifies the importance of promptly identifying the main etiology in every case of stroke which is more important in patients with recurrent stroke. Etiology often includes a malignancy in its early stages but keen observation and correct selection of treatment is required for further prevention of stroke along with the management of main etiology.

Keywords- Stroke, Multiple Myeloma, Amyloidosis, Platelets

References

  1. Kristinsson SY et al. Arterial and venous thrombosis in monoclonal gammopathy of undetermined significance and multiple myeloma: a population‐based study. Blood. 2010;115(24):4991–4998.
  2. Libourel EJ et al. High incidence of arterial thrombosis in young patients treated for multiple myeloma: results of a prospective cohort study. Blood. 2010;116(1):22–26.
  3. Eby C. Pathogenesis and management of bleeding and thrombosis in plasma cell dyscrasias. Br J Haematol. 2009;145(2):151–163.
  4. Lee GY et al. Risk of stroke in patients with newly diagnosed multiple myeloma: a retrospective cohort study. Hematological oncology. 2017 Dec;35(4):726-33.
  5. Cho KH et al. Embolic infarction associated with cardiac amyloidosis. J Clin Neurol. 2005 Apr;1(1):92-6.

Corresponding Author

Dr Ojas Ahuja

Department of Neurosciences, Max Super Speciality Hospital, Saket, New Delhi