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Multiple Myeloma

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Signs and Symptoms

Many people with multiple myeloma show no symptoms for many years (so-called asymptomatic myeloma). Eventually, most develop some signs and symptoms of the disease. These may include:

  • Weakened bones and bone pain; as bones weaken, soft spots and fractures may develop.
  • Carpal tunnel syndrome is a common complication.
  • Destruction of the bone that frequently increases the level of calcium in the blood, leading to symptoms of hypercalcemia such as loss of appetite, nausea, thirst, fatigue, constipation, and confusion.
  • An increase in abnormal plasma cells that decreases the number of normal red blood cells, white blood cells, and platelets, often resulting in anemia, recurrent infections, and excessive bleeding and bruising.
  • Kidney disease may develop. Bence Jones proteins can affect the kidneys and may permanently damage them.
  • In some cases, an increase in the thickness (viscosity) of the blood may lead to headaches or problems with vision. Hyperviscosity syndrome results from the increased presence of serum immunoglobulin proteins or blood cells causing an abnormal "thickness" to the blood. This, in turn, may cause nervous system symptoms, vision impairment, and/or excessive bleeding from the gums or nosebleeds. Up to 10% of patients with multiple myeloma and 10%-30% of patients with Waldenstrom macroglobulinemia may show increased serum viscosity.

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