pituitrin and Multiple-Myeloma

Topics: Acidosis; Acute Kidney Injury; Alkalosis; Amyloidosis; Hodgkin Disease; Humans; Hyperkalemia; Hypernatremia; Hypertension, Renal; Hypokalemia; Kidney; Kidney Concentrating Ability; Kidney Diseases; Multiple Myeloma; Neoplasms; Nephritis; Nephrotic Syndrome; Osmolar Concentration; Urine; Vasopressins; Water-Electrolyte Balance

Topics: Diuretics; Humans; Inappropriate ADH Syndrome; Multiple Myeloma; Vasopressins

Topics: Aged, 80 and over; Autoantibodies; Diagnosis, Differential; Edema; Humans; Male; Multiple Myeloma; Syndrome; Synovitis; Vasopressins

Bence Jones proteins were capable of hydrolyzing a peptide bond between arginine-8 and the C-terminal glycinamide of vasopressin. This peptidolytic activity obeyed typical Michaelis-Menten kinetics and exhibited optimal activity at pH 8.2 and Km of 0.6-1.9 mM. The catalytic efficiency, kcat/Km, was calculated to be 0.8 to 5.8 min(-1)M(-1). The Bence Jones proteins displayed turnover, an essential feature of enzymes. These results suggest that slow proteolysis, especially in the renal tubules which are 'saturated' with Bence Jones proteins, may have a pathophysiological significance for various nephropathies often associated with multiple myeloma with Bence Jones proteinuria.

Topics: Arginine; Bence Jones Protein; Catalysis; Glycine; Humans; Hydrogen-Ion Concentration; Hydrolysis; Kinetics; Multiple Myeloma; Vasopressins

A single case of gastric plasmacytoma showing unusual clinical and pathological features is described. The patient had gluten sensitive enteropathy, and showed increased circulating IgA levels prior to gastrectomy. Progression of the disease was associated with both K and L light chain proteinuria, hypoalbuminaemia, and vasopressin resistant polyuria. Pathological investigation revealed the coexistence of IgA secreting soft tissue plasmacytoma, with IgG secreting myeloma. The significance of these findings is discussed.

Topics: Autopsy; Blood Transfusion; Celiac Disease; Gastrectomy; Glutens; Humans; Immunoglobulin Fragments; Immunoglobulins; Kanamycin; Lymph Nodes; Male; Middle Aged; Multiple Myeloma; Osmolar Concentration; Plasmacytoma; Polyuria; Proteinuria; Serum Albumin; Sodium; Stomach; Stomach Neoplasms; Vasopressins

In uncharacteristic clinical symptomatology the excess of water or the water intoxication render themselves conspicuous less by the signs of an increased fluid content than by central-nervous disturbances. Among the results of laboratory examinations the hypoosmolarity measured cryoscopically always, the hyponatraemia in most cases prove the excess of free water. Exceptions are discussed. A decreased capacity of the elimination of water pathogenetically plays a larger role than primarily excessive water supply. Apart from acute and chronic renal insufficiency the various forms of the Schwartz-Bartter-syndrome (inadequate ADH-secretion) play an increasingly more important role. The therapy demands the reduction of every supply of free water, the treatment of the evoking cause and only in cases of exception the administration of hypertonic saline solution, at the most dialysis treatment.

Topics: Diabetic Coma; Diagnosis, Differential; Humans; Kidney Diseases; Multiple Myeloma; Osmolar Concentration; Sodium; Vasopressins; Water Intoxication; Water-Electrolyte Balance

Topics: Aged; Humans; Hypopituitarism; Male; Multiple Myeloma; Pituitary Neoplasms; Prednisolone; Vasopressins