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Pemphigus vulgaris as the first manifestation of multiple myeloma: a case report

Overview of attention for article published in Journal of Medical Case Reports, September 2018
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Title
Pemphigus vulgaris as the first manifestation of multiple myeloma: a case report
Published in
Journal of Medical Case Reports, September 2018
DOI 10.1186/s13256-018-1791-z
Pubmed ID
Authors

Fandresena Arilala Sendrasoa, Irina Mamisoa Ranaivo, Mendrika Fifaliana Rakotoarisaona, Onivola Raharolahy, Naina Harinjara Razanakoto, Malalaniaina Andrianarison, Lala Soavina Ramarozatovo, Fahafahantsoa Rapelanoro Rabenja

Abstract

The association between pemphigus and malignancy has been well documented for decades but an association between pemphigus vulgaris and multiple myeloma is unusual. We report a case of pemphigus vulgaris revealing multiple myeloma. A 55-year-old Malagasy man, with no significant past medical history, presented with bullous and erosive skin lesions involving his trunk and scalp for the last 2 months. He had no mucous membrane involvement. A diagnosis of pemphigus vulgaris was made on skin biopsy and direct immunofluorescence of perilesional skin revealing immunoglobulin G deposition in the intercellular spaces in the epidermis. In an enzyme-linked immunosorbent assay, his serum autoantibody index against desmoglein-1 and 3 was found to be 112 RU/mL and 34 RU/mL respectively. Serum immunoelectrophoresis showed a monoclonal gammopathy with a markedly elevated immunoglobulin G level (2880 mg/dL) in association with a lambda free light chain. Bone marrow aspirate showed 6% plasma cell infiltration. Further investigations, including creatinine blood test and whole body radiographic examinations, showed that he had initially clinical stage I multiple myeloma of the immunoglobulin G-λ type. Six months later, bone tomography revealed vertebral compression fractures of the thoracic and lumbar spine that correlated with his back pain topographically. Anti-myeloma treatment including melphalan and prednisone led to an immediate decline in monoclonal immunoglobulin G concentration. Skin and hematologic remission were maintained for 12 months. Absence of mucosal involvement, lack of vacuolar degeneration at the interface, and absence of apoptotic, dyskeratotic keratinocytes ruled out paraneoplastic pemphigus in our case. Pemphigus vulgaris should be considered even if possible underlying disease for which paraneoplastic pemphigus is recognized is present.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 18 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 18 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 3 17%
Professor 2 11%
Librarian 1 6%
Other 1 6%
Student > Doctoral Student 1 6%
Other 2 11%
Unknown 8 44%
Readers by discipline Count As %
Medicine and Dentistry 7 39%
Engineering 1 6%
Unknown 10 56%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 September 2018.
All research outputs
#17,989,170
of 23,103,436 outputs
Outputs from Journal of Medical Case Reports
#1,934
of 3,966 outputs
Outputs of similar age
#241,159
of 336,158 outputs
Outputs of similar age from Journal of Medical Case Reports
#57
of 91 outputs
Altmetric has tracked 23,103,436 research outputs across all sources so far. This one is in the 19th percentile – i.e., 19% of other outputs scored the same or lower than it.
So far Altmetric has tracked 3,966 research outputs from this source. They receive a mean Attention Score of 3.9. This one is in the 42nd percentile – i.e., 42% of its peers scored the same or lower than it.
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We're also able to compare this research output to 91 others from the same source and published within six weeks on either side of this one. This one is in the 27th percentile – i.e., 27% of its contemporaries scored the same or lower than it.