Metastatic pulmonary calcinosis and leukocytoclastic vasculitis in a patient with multiple myeloma

Turk J Haematol. 2012 Dec;29(4):397-400. doi: 10.5505/tjh.2012.23600. Epub 2012 Dec 5.

Abstract

Both leukocytoclastic vasculitis and metastatic pulmonary calcification are conditions that rarely occur during the course of multiple myeloma. We present a multiple myeloma patient that had severe dyspnea due to metastatic pulmonary calcinosis, and ulceronecrotic skin lesions caused by leukocytoclastic vasculitis. After 3 courses of standarddose chemotherapy all skin and pulmonary lesions disappeared. Autologous peripheral stem cell transplantation was performed and during 1 year of follow-up the patient was in complete remission; after 1 year, laboratory test results indicated disease relapse. Although the patient was treated with bortezomib and dexamethasone, the disease progressed. Non-myeloablative allogeneic stem cell transplantation was performed, but despite of all treatment the patient died due to disease progression.

Conflict of interest: None declared.

Hem lökositoklastik vaskülit hemde metastatik pulmoner kalsifikasyon, multipl myelomda nadir olarak görülmektedir. Biz, lökositoklastik vaskulit nedeniyle gelişen ülseronekrotik cilt lezyonları ve ciddi dispneye yol açan metastatik pulmoner kalsifikasyonla tanısı konan bir multipl myelom hastasını sunmak istedik. Üç kür standart doz kemoterapi sonrası hastanın hem cilt lezyonları hemde pulmoner lezyonları düzeldi. Otolog kök hücre nakli yapılan hasta 1 yıl tam remisyonda izlendi. Daha sonra laboratuvar testlerinde relaps saptandı. Hastaya bortezomib ve deksametazon başlandı. Bu tedaviye rağmen progresyonu olan hastaya myeloablatif olmayan rejimle allojeneik kök hücre nakli yapıldı. Bütün tedavilere rağmen hasta progresif hastalıkla kaybedildi.

Keywords: Leukocytoclastic vasculitis; Metastatic calcification; Multiple myeloma.