In the absence of any characteristic symptoms and its widespread presence in the organs, multiple myeloma is tough to diagnose. This is the reason that many-a-times diagnosis of multiple myeloma is missed leading to delay in treatment.

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Can You Be Misdiagnosed With Multiple Myeloma?

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Can You Be Misdiagnosed With Multiple Myeloma?

Misdiagnosis of multiple myeloma leads to disastrous results as the condition may rapidly progress in an advanced stage. Further, the condition may also result in the destruction of bone and also leads to renal failure. The condition should be diagnosed as early as possible along with the accurate stage of the disease. This will help the oncologist to provide appropriate treatment for the management of the disease. Many-a-times, the diagnosis of multiple myeloma is difficult and thus can be misdiagnosed with a variety of diseases related to bone, kidney or inflammation in the body. Thus, proper diagnostic techniques should be used, and the patient should be comprehensively evaluated to prevent the misdiagnosis of this condition. Misdiagnosis of multiple myeloma is due to the fact that most of the symptoms of this disease overlap with the symptoms of other common diseases. Symptoms such as fatigue, high level of calcium, bone pain, kidney problems, weight loss, and widespread pain are not exclusive to multiple myeloma and are found in various other diseases. Other reasons for misdiagnosis of the condition include the sharing of incomplete medical history and testing results to the doctor or physician is not experienced enough to correctly diagnose the disease. Multiple myeloma can be misdiagnosed to the following disease:

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  1. Seronegative Rheumatoid Arthritis- The patient of Multiple myeloma may be misdiagnosed for rheumatoid arthritis as the symptoms of both the conditions are almost similar. Further, there have been cases when both the condition occurs simultaneously, and the physician only diagnoses rheumatoid arthritis. It has been found in the literature that Multiple myeloma mimics the symptoms of seronegative rheumatoid arthritis leading to the progression of disease in an advanced stage with poor outcome. In the case of misdiagnosis, if the patient does not respond to the treatment for rheumatoid arthritis, prompt reexamination should be done to identify the presence of any other serious disease.(1)
  2. Rheumatic Disease- Apart from the seronegative rheumatoid arthritis, the multiple myeloma can be misdiagnosed with various other rheumatoid diseases. Despite fulfilling the criteria for the misdiagnosed condition, the symptoms of the patient were due to multiple myeloma. In one case, the patient suffering from multiple myeloma was misdiagnosed with a rare disease known as Scleromyxedema. Initially diagnosed with systemic sclerosis, absence of Raynaud’s phenomenon makes the diagnosis to change to Scleromyxedema. Later on, multiple myeloma panel was done, and it was found that it was multiple myeloma that was presenting the thickening of the skin as seen in sclerosis. In another case, the patient was misdiagnosed with giant cell arteritis due to the presence of high ESR and monocular blindness, but later on, it was found that the reason for the symptoms was multiple myeloma which leads to hyperviscosity syndrome leading to blindness.
  3. Somatic Symptom Disorder- This case provides the learning that complete diagnosis including the image diagnosis should be done before arriving at any conclusion. The patient of this case was presented with the widespread pain in the upper body. After being treated for somatic symptom disorder for 6 months, he has eventually diagnosed with multiple myeloma due to the reason that treatment of somatic symptom disorder was ineffective. Complete imaging of the painful parts should be done to exclude the possibility of multiple myeloma.(2)
  4. Orchitis- This is a reverse case in which the patient has orchitis and he was diagnosed with multiple myeloma. This misdiagnosis was due to the fact that symptoms of both the disease are almost similar with different pathophysiology.

Conclusion

Due to the overlap of the symptoms with various conditions, multiple myeloma can be misdiagnosed with diseases such as rheumatoid arthritis, giant cell arteritis, somatic symptom disorder, and orchitis.

References:  

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Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: May 24, 2019

This article does not provide medical advice. See disclaimer

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