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Intest Res. 2017 Apr;15(2):249-254. doi: 10.5217/ir.2017.15.2.249. Epub 2017 Apr 27.

Crohn's disease and smoldering multiple myeloma: a case report and literature review.

Author information

1
Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
2
Department of Internal Medicine, Graduate School, Kyung Hee University, Seoul, Korea.
3
Division of Medical Oncology and Hematology, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
4
Division of Gastroenterology, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.

Abstract

Crohn's disease (CD) is a chronic inflammatory bowel disease (IBD) that presents with abdominal pain, weight loss, and diarrhea. Although the etiology has not been fully elucidated, both environmental and genetic causes are known to be involved. In chronic inflammatory conditions such as IBD, B lymphocytes are chronically stimulated, and they induce monoclonal expansion of plasma cells, sometimes resulting in monoclonal gammopathy of undetermined significance. Immunomodulators that are commonly used to control inflammation, such as tumor necrosis factor-α (TNF-α) blockers could increase the possibility of hematologic malignancy. The pathogenesis of multiple myeloma in association with TNF-α inhibitor therapy is attributed to decreased apoptosis of plasma cell populations. Here, we describe a case of a 36-year-old male patient who was diagnosed with immunoglobulin A subtype smoldering multiple myeloma during the treatment for CD with infliximab and adalimumab. We report this case along with a review of the literature on cases of multiple myeloma that occurred in conjunction with CD.

KEYWORDS:

Crohn disease; Multiple myeloma; Tumor necrosis factor-alpha

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