Chest pain in the course of multiple myeloma - a clinical case study

Introduction: Multiple myeloma (MM) is a rare blood cell proliferative disease characterized by the accumulation and proliferation of monoclonal plasmocytes. Clinical picture of MM includes bone pain, underlying osteolytic lesions, osteopenia or osteoporosis that often lead to pathological fractures. Aim: To draw attention to the unusual cause of chest pain and the holistic approach to analgesic therapy in patients with MM. Case report: A clinical case of a 66-year-old patient with chest pain intensified when moving and deep breathing was presented and cardiological and gastroenterological reasons were excluded. Initially, non-steroidal analgesics and weak opioids were used in the treatment with good effect, however, as time was passing the pain symptoms progressed. Diagnostic imaging was complemented by computed tomography which revealed massive destructive changes within the ribs with the presence of soft tissue masses infiltrating adjacent muscles. Based on additional tests, the patient was diagnosed with MM. Optimization of analgesic therapy has brought permanent pain relief and improved his quality of life. Summary: The modern approach to anelgesia in patients with MM includes not only the use of analgesics, but also radiotherapy, bisphosphonates/zoledronic acid, orthopaedic treatment and chemotherapy

Distinct characteristics of multisystem inflammatory syndrome in children in Poland

International audienceAbstract During the winter months of 2020/2021 a wave of multisystem inflammatory syndrome in children (MIS-C) emerged in Poland. We present the results of a nationwide register aiming to capture and characterise MIS-C with a focus on severity determinants. The first MIS-C wave in Poland was notably high, hence our analysis involved 274 children. The group was 62.8% boys, with a median age of 8.8 years. Besides one Asian, all were White. Overall, the disease course was not as severe as in previous reports, however. Pediatric intensive care treatment was required for merely 23 (8.4%) of children, who were older and exhibited a distinguished clinical picture at hospital admission. We have also identified sex-dependent differences; teenage boys more often had cardiac involvement (decreased ejection fraction in 25.9% vs. 14.7%) and fulfilled macrophage activation syndrome definition (31.0% vs. 15.2%). Among all boys, those hospitalized in pediatric intensive care unit were significantly older (median 11.2 vs. 9.1 years). Henceforth, while ethnicity and sex may affect MIS-C phenotype, management protocols might be not universally applicable, and should rather be adjusted to the specific population