A 80-year-old man was admitted because of acute-onset thrombocytopenia and renal failure . He was diagnosed with Bence Jones ( lambda ) -type multiple myeloma associated with sepsis with methicillin-resistant Staphylococcus aureus. On admission, serum amylase activity was elevated to 1,814 IU/l (98% salivary type; S-amylase ). Several days after admission, he developed bilateral myelomatous pleuritis. The activity of s-amylase in the effusion was 5,495 IU/l. Myeloma cells in the pleural effusion were positive for cytoplasmic amylase with an antibody against human amylase . High S-amylase activity was detected in the supernatant of cultured myeloma cells in the effusion. Furthermore, s-amylase gene expression was detected by RT-PCR. A diagnosis of amylase-producing multiple myeloma was made. The patient died of renal insufficiency complicated by severe DIC. We report a rare case of amylase-producing myeloma confirmed by immunocytochemistry, culture method, and gene expression.
Mori M, Maruoka H, Nagai Y, Fujita H, Togami K, Tabata S, Kurata M, Matsushita A, Nagai K, Tanaka K, Yamashiro A, Takahashi T.
Department of Hematology and Clinical Immunology, Kobe City Medical Center General Hospital,Rinsho Ketsueki. 2007 Nov;48(11):1484-8.
