Multiple Myeloma in MRCP
Multiple myeloma is always an interesting disease to diagnose because patients might just present to you with acute kidney injury! My university lecturer told me once, when an elderly patient comes to see you with kidney failure with no previous medical history, you must always look for multiple myeloma or drug induced ( especially NSAID!)
Another interesting fact about Multiple myeloma is Urine Bence Jones protein. I still remember during medical school time, lecturer always asked us about how to differentiate Urine Bence Jones protein from proteinuria at bed side, I hope you all know the way!
Urine Bence Jones is named after Henry Bence Jones, a famous British physician and chemist. In 1848, he was cited as the driving force for the investigation of an unusual chemical analysis discovered in the urine of a patient with myeloma in a paper titled "On the microscopical character of mollities ossium" (mollities ossium was the name for myeloma, which at the time was thought of as a bone disease based on the osteolytic bone metastases which resulted).
As for you, remember that Multiple myeloma patients always present with hypercalcemia, osteolytic bone lesions ( bone pain) and classical bone marrow findings ( proliferation of plasma cell in bone marrow). Patients might present with polyuria because hypercalcemia is one of the causes for nephrogenic diabetes insipidus!
