[Dimamar]

Multiple myeloma & inflammatory bowel disease (IBD)

by Dimamar on Mon Aug 12, 2019 8:22 pm

Dear knowledgeable and compassionate brothers and sisters

I've been smoldering for 3 years (that I know of). I have IgG kappa smoldering multiple myeloma, but my IgM and IgA are both very low (barely existent) and on a down trend. My M-protein is around 0.5 and my kappa-lambda ratio is 20-30.

I've had irritable bowel syndrome (IBS) all my life, but a few months ago, a month after a case of flu and bronchitis, and after a stressful work trip and also road rash that happened around same time that got inflamed (fell on a dirty pavement walking to work there), I started having blood and mucus.

An eventual gastroenterology visit, test and procedures led to a diagnosis of ulcerative proctitis, a subset of inflammatory bowel disease (IBD).

The IBD was rough, but at this point it's healed, and at least I do not have the worst symptoms anymore.

The biopsy that led to the IBD diagnosis suggested that perhaps the inflammation was either drug (ibuprofen-like) or infection induced as first choice, while chronic IBD a second choice.

I have been reading that IgA deficiency may affect gastrointestinal function (IBD is an autoimmune disorder). Thus, I was wondering if there is any research suggesting a link between multiple myeloma and IBD.

Somehow I feel that my immune system was weakened by bronchitis and then stress, and this could've caused the inflammation in the rectum.

Thank you, and all the best!

[Multibilly]

Re: Multiple myeloma & inflammatory bowel disease (IBD)

by Multibilly on Wed Aug 14, 2019 7:49 am

Hi Dimamar,

If you do a quick search on the web of "IBD myeloma", you will find quite a few articles like this one:

Shimanovsky, A, et al., "Autoimmune manifestations in patients with multiple myeloma and monoclonal gammopathy of undetermined significance," BBA Clinical, December 2016 (full text of article)

In a nut, there has been research that suggests that autoimmune diseases such as IBD can trigger the development of MGUS (which in turn can then progress to smoldering myeloma, multiple myeloma, etc.).

While I'm certainly not a doctor, is also seems plausible to me that once you are on the myeloma spectrum and your immune system is compromised, that this in turn would could further exacerbate the autoimmune disease that may have triggered the development of MGUS in the first place. But again, I'm not a doctor, so it would be best to discuss this with your oncologist.

[Dimamar]

Re: Multiple myeloma & inflammatory bowel disease (IBD)

by Dimamar on Thu Aug 15, 2019 10:04 pm

Thank you, Multibilly, for the thoughtful response! You may not be a doctor, but you'd sure make a great one!

As far as this goes, it is a question of what was first, the chicken or the egg

I've had GI problems all my life, and it so happened I had a second colonoscopy 3 years ago and it was good. At the same time, a bone marrow biopsy showed 20% of plasma cells, thus the myeloma diagnosis.

So myeloma came first it appears.

I've also seen articles suggesting that IgA deficiency is correlated with autoimmune disorders.

By coincidence, I had my regular multiple myeloma visit yesterday and asked the question I've asked here. My doctor appeared very upset that I have the IBD diagnosis, and said "It ruins people's lives," while he's on the less cautious side as far as myeloma approach and normally is easy­going.