Multiple Myeloma: Ã¢ÂÂUncommon Immunogamopathy MaculopathyMohd Syafiq Bin Azman12*, Shawarinin Binti Jusoh1 and Akmal Haliza Binti Zamli1
- *Corresponding Author:
- Mohd Syafiq bin Azman
Hospital Tengku Ampuan Afzan
Jalan Tanah Putih, Malaysia
E-mail: [email protected]
Received date: May 18, 2017; Accepted date: May 29, 2017; Published date: June 10, 2017
Citation: Azman MSB, Jusoh SB, Zamli AHB (2017) Multiple Myeloma: “Uncommon Immunogamopathy Maculopathy”. Med Rep Case Stud 2: 137. doi: 10.4172/2572-5130.1000137
Copyright: © 2017 Azman MSB, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract Purpose: To report a case of symptomatic immunogammopathy maculopathy in multiple myeloma despite lower level of IgM (<7000 mg/dl) in a non-diabetic patient. Case report: We report a 53-year-old Malay man with underlying hypertension and newly diagnosed multiple myeloma, complained of progressive blurring of vision in both eyes over 2 months. Visual acuity with best correction was 6/36 in both eyes. No relative afferent pupillary defect. Slit lamp biomicroscopy showed minimal nuclear cataract in both eyes. No evidence of cornea crystals. Funduscopic examination revealed bilateral macula neurosensory detachment with yellow-white subretinal precipitates. The retinal veins also appeared distended. Fluorescein angiography showed no evidence of macula hyperflorescence from the retinal vasculature or retinal pigment in either eye. Baseline laboratory evaluation before treatment revealed microcystic anaemia, thrombocytopenia and abnormal serum protein electrophoresis IgM Kappa paraproteinemia of 5890 mg/dl. Conclusion: Symptomatic immunogammopathy maculopathy in multiple myeloma is still possible despite lower levels of IgM (<7000 mg/dl) in a non-diabetic patient, therefore prompt treatment is necessary to prevent irreversible visual loss.