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A rare case report of multiple myeloma presenting with paralytic ileus and type II respiratory failure due to hypercalcemic crisis.

Abstract Paralytic ileus is characterized by the signs and symptoms of intestinal obstruction but without any mechanical lesions in the intestinal lumen. Several medical and surgical conditions can lead to this ailment, such as electrolyte disturbances that impair intestinal motility. However, hypercalcemia secondary to multiple myeloma as a major cause of paralytic ileus has rarely been reported.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29384906
OWN - NLM
STAT- MEDLINE
DCOM- 20180209
LR  - 20180209
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 52
DP  - 2017 Dec
TI  - A rare case report of multiple myeloma presenting with paralytic ileus and type
      II respiratory failure due to hypercalcemic crisis.
PG  - e9215
LID - 10.1097/MD.0000000000009215 [doi]
AB  - RATIONALE: Paralytic ileus is characterized by the signs and symptoms of
      intestinal obstruction but without any mechanical lesions in the intestinal
      lumen. Several medical and surgical conditions can lead to this ailment, such as 
      electrolyte disturbances that impair intestinal motility. However, hypercalcemia 
      secondary to multiple myeloma as a major cause of paralytic ileus has rarely been
      reported. PATIENT CONCERNS: The patient got severe constipation with difficulty
      in the passage of both gas and feces for 7 days. DIAGNOSES: The patient was
      diagnosed with a small intestinal obstruction initially and then developed type
      II respiratory failure. Investigations revealed hypercalcemic crisis, and
      examination of a bone marrow aspirate was consistent with multiple myeloma.
      INTERVENTIONS: Conservative treatment was administered for the intestinal
      obstruction, consisting of food and water deprivation, gastrointestinal
      decompression, colonic irrigation, intravenous fluid transfusion,
      anti-inflammatory therapy. Invasive respiratory support was provided after type
      II respiratory failure occurred and salmon calcitonin was used to reduce the
      blood calcium level. Further therapy was given by the Department of Hematology
      and Oncology in our hospital after the diagnosis of multiple myeloma. OUTCOMES:
      Spontaneous respiration and gastrointestinal function were restored after the
      correction of hypercalcemia. LESSONS: An appropriate diagnostic approach is
      needed in emergency practice to identify the paralytic ileus and type II
      respiratory failure caused by hypercalcemia secondary to multiple myeloma.
CI  - Copyright (c) 2017 The Authors. Published by Wolters Kluwer Health, Inc. All
      rights reserved.
FAU - Guo, Yuchen
AU  - Guo Y
AD  - Department of Gastrointestinal Surgery, First Hospital of Jilin University.
FAU - He, Liang
AU  - He L
AD  - Department of Gastrointestinal Surgery, First Hospital of Jilin University.
FAU - Liu, Yiming
AU  - Liu Y
AD  - Department of Pharmacy, Second Hospital of Jilin University, Changchun, China.
FAU - Cao, Xueyuan
AU  - Cao X
AD  - Department of Gastrointestinal Surgery, First Hospital of Jilin University.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Female
MH  - Humans
MH  - Hypercalcemia/*complications/diagnosis/therapy
MH  - Intestinal Pseudo-Obstruction/*etiology
MH  - Middle Aged
MH  - Multiple Myeloma/*complications/*diagnosis/therapy
MH  - Respiratory Insufficiency/*etiology
EDAT- 2018/02/01 06:00
MHDA- 2018/02/10 06:00
CRDT- 2018/02/01 06:00
PHST- 2018/02/01 06:00 [entrez]
PHST- 2018/02/01 06:00 [pubmed]
PHST- 2018/02/10 06:00 [medline]
AID - 10.1097/MD.0000000000009215 [doi]
AID - 00005792-201712290-00014 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Dec;96(52):e9215. doi: 10.1097/MD.0000000000009215.