Managing Critical Emergent Situations in Multiple Myeloma

Cord compression is a major emergent situation in multiple myeloma, with acute neurologic changes in the lower extremities being important signs./nAcute renal failure and hypercalcemia are critical complications that may require urgent interventions like dialysis./nMultiple myeloma patients are predisposed to serious infections, including pneumonias and streptococcal pneumonia, due to their impaired humoral immunity./nUnusual infections like listeria and CMV can occur in myeloma patients, so atypical presentations should be considered./nIn the emergency department, the acronym CRAB (hypercalcemia, renal failure, anemia, and bone lesions or pain) can help in identifying multiple myeloma./nDiagnosis of multiple myeloma involves investigating immunoglobulins, serum and urine protein electrophoresis, and serum free light chain assay./nPatients with multiple myeloma are immunocompromised both from the disease itself and the medications they receive.