Dirençli Hiperkalsemi Ýle Presente Olan Bir Multiple Miyelom Vakasý

48 yaþýndaki kadýn hastanýn hipertansiyon öyküsü dýþýnda bir hastalýðý bulunmamaktadýr. Halsizlik, sýrt-bel aðrýsý, yürüme güçlüðü, þiddetli hiperkalsemi (17,7 mg /dL) ve akut böbrek hasarý ile kliniðimize getirildi. Hidrasyon ile böbreðin fonksiyon testleri düzeldi. Ancak hiperkalsemi hidrasyona yanýt vermedi. Bifosfonat, kortikosteroid, kalsitonin gibi antihiperkalsemik tedavi protokolleri denenmesine raðmen hiperkalsemisi düzene girmedi. Dirençli hiperkalsemi düþünüldü. Hiperkalsemi etyolojik analizinde, kemik iliði ince iðne aspirasyon tetkikiyle multiple miyelom tanýsýný aldý Siklofosfamid-velcade-deksametazon kemoterapi kürü (siklofosfamid, bortezomib, deksametazon) verildi. Sonrasýnda serum kalsiyum düzeyi düzene girebildi. Multipe miyelom çoðunlukla ileri yaþ erkeklerde görülür. Vakamýzýn genç bir kadýn olmasý ve dirençli hiperklasemisi onu eþsiz kýlmaktadýr.

A Case of Multiple Myeloma Presenting With Resistant Hypercalcemia

48-year-old female patient has no disease other than a history of hypertension. She was brought to our clinic with weakness, back pain, walking difficulty, severe hypercalcemia (17.7 mg/dL) and acute kidney injury. Function tests of the kidney improved with hydration. However, hypercalcemia did not respond to hydration. Although antihypercalcemic treatment protocols such as bisphosphonate, corticosteroid, and calcitonin were tried, hypercalcemia did not regulate. Resistant hypercalcemia was considered. In the etiological analysis of hypercalcemia, multiple myeloma was diagnosed with bone marrow fine needle aspiration examination. Cyclophosphamide-velcade-dexamethasone chemotherapy cure (cyclophosphamide, bortezomib, dexamethasone) was given. Afterwards, the serum calcium level could be regulated. Multiple myeloma is mostly seen in older men. The fact that our case was a young woman and her resistant hyperclaemia make her unique.