Multiple myeloma associated with bone sclerosis and peripheral neuropathy

Bone sclerosis is an unusual manifestation of multiple myeloma. The bone lesions in this disease are classically osteolytic, or may be non-specific, manifesting as diffuse osteoporosis (Lichtenstein and Jaffe, 1947; Heizer and Schwartzmann, 1952; Carson, Ackerman and Maltby, 1955; Williams, 1958; Yentis, 1961). But the occasional association of multiple myeloma and solitary plasmocytoma with osteosclerotic lesions is becoming increasingly recognised (Krainin, D'Angio and Smelin, 1949; Odelberg-Johnson, 1959; Yentis, 1961; Evison and Evans, 1967; Morley and Schwieger, 1967). Bone sclerosis occurring as a manifestation of multiple myeloma must be differentiated from bone sclerosis occurring in this disease as a result of deep X-ray therapy (Carson et al., 1955; Williams, 1958), chemotherapy (Dawson, 1968), urethane therapy (Rundles and Reeves, 1950), deposition of amyloid (Schintz, Baensch, Friedl and Uehlinger, 1952) and callus formation with pathological fractures (Williams, 1958). Peripheral neuropathy associated with multiple myeloma with sclerotic bone lesions has been first described by Crow (1956) and it has been suggested that this may be more than a chance association (Aguayo, Thompson and Humphrey, 1964; Morley and Schwieger, 1967). We would like to present a case of multiple myeloma which presented with peripheral neuropathy and was found radiologically to have osteosclerotic lesions in many bones. A man, aged 48 was admitted to hospital complaining of numbness and weakness in both legs for one year, which had been getting progressively worse, resulting prior to admission in inability to move the lower limbs. His other main complaint was low back pain for eight months.