THU0662 THE FREQUENCY OF MULTIPLE MYELOMA IN PATIENTS WITH ELEVATED ACUTE PHASE RESPONSE AND LOW BACK PAIN IN A RHEUMATOLOGY OUTPATIENT CLINIC

Background Multiple myeloma (MM), is a malignant hematological monoclonal neoplasm of plasma cells. Main clinical findings of MM are anemia, bone pain, elevated erythrocyte sedimentation rate and CRP levels, M-spike on protein electrophoresis, monoclonal protein in serum or urine. Anemia, low back pain and elevated acute phase reactants are frequently seen symptoms of patients who admit to a rheumatology outpatient. Objectives We aimed in this study to evaluate the frequency of plasma cell malignancies in patient with elevated acute phase reactants and low back pain. Methods 4100 rheumatology patients from rheumatology outpatient clinic are screened retrospective for >50 age, elevated ESR, anemia and back pain or hip pain. 548 patients (312 female and 236 male, mean age: 61±6) fulfilled these criteria and these patients are screened with protein electrophoresis for monoclonal gammopathies. If M-spike is seen in protein electrophoresis, patients are evaluated for lambda and kappa chains in serum and urine. Results 3 patients were diagnosed for multiple myeloma. All three patients had moderate to severe anemia (Hgb 70 mm/h. Two patients are classified as rheumatoid arthritis and one patient had no inflammatory rheumatological diseases. 7 patients were diagnosed as MGUS and 5 patients from this group is diagnosed as rheumatoid arthritis and 2 patient polymyalgia rheumatica. In MGUS patient group mean ESR level was 44±9 mm/h and mean Hgb level was 10,8±6 g/dl. Conclusion We found no increased frequency for MM in rheumatology outpatient clinic. Patients >50 years with high ESR and moderate to severe anemia should be screened with protein electrophoresis for monoclonal gammopathies. References [1] A population study to define the incidence and survival of multiple myeloma in a National Health Service Region in UK. Phekoo KJ et al. Br J Haematol. (2004) Disclosure of Interests None declared