Dysphagia as a Clinical Manifestation of Monoclonal Gammopathy of Undetermined Significance: A Case Report
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Swallowing can be affected by a variety of systemic diseases. The etiology of dysphagia in the geriatric population isusually overlooked due mainly to a presumed diagnosis of presbyphagia or difficulty in revealing the direct cause. On the other hand, dysphagia can be a meaningful clinical sign of premalignant systemic disease. A 78-year-oldman, without any prior medical or family history, was admitted with the chief complaint of dysphagia with recentaspiration pneumonia. Instrumental swallowing tests revealed a severe degree of dysphagia due to decreased laryngopharyngeal sensation and weakness of the pharyngeal constrictor muscles. Extensive workup, including electromyography and laboratory tests, revealed severe sensorimotor peripheral polyneuropathy related to monoclonal gammopathy. Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant precursor of multiple myeloma, which is characterized by the proliferation of monoclonal proteins. These conditions are often associated withperipheral polyneuropathy, ataxia, and sometimes even muscle weakness. Although dysphagia can occur in othersystemic disorders, such as vasculitis or paraneoplastic syndrome-related malignancies, there are few reports of dysphagia related to MGUS. The patient was followed up for three years. The MGUS showed no further progression,but the patient showed no improvement, indicating a protracted clinical course and poor prognosis when dysphagiais related to MGUS.
Abstract
Swallowing can be affected by a variety of systemic diseases. The etiology of dysphagia in the geriatric population isusually overlooked due mainly to a presumed diagnosis of presbyphagia or difficulty in revealing the direct cause. On the other hand, dysphagia can be a meaningful clinical sign of premalignant systemic disease. A 78-year-oldman, without any prior medical or family history, was admitted with the chief complaint of dysphagia with recentaspiration pneumonia. Instrumental swallowing tests revealed a severe degree of dysphagia due to decreased laryngopharyngeal sensation and weakness of the pharyngeal constrictor muscles. Extensive workup, including electromyography and laboratory tests, revealed severe sensorimotor peripheral polyneuropathy related to monoclonal gammopathy. Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant precursor of multiple myeloma, which is characterized by the proliferation of monoclonal proteins. These conditions are often associated withperipheral polyneuropathy, ataxia, and sometimes even muscle weakness. Although dysphagia can occur in othersystemic disorders, such as vasculitis or paraneoplastic syndrome-related malignancies, there are few reports of dysphagia related to MGUS. The patient was followed up for three years. The MGUS showed no further progression,but the patient showed no improvement, indicating a protracted clinical course and poor prognosis when dysphagiais related to MGUS.
참고문헌 (10)
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