An unusual case of multiple myeloma being unmasked post influenza vaccination
A 65 year old female with diabetes and asthma presented with subjective chills, lethargy, arthralgias, and myalgias lasting over 2 days. She mentioned having received the inactivated influenza vaccine 5 days back. Vital signs were stable apart from sinus tachycardia (HR 143/min). Labs, including CBC and BMP, were within normal limits except for baseline normocytic anemia (Hb 10.7 g/dl). Serum calcium was 10.8 mg/dl. She was observed for a day, and was discharged home with supportive treatment. She presented a day later with persistent flu like symptoms. Labs were significant for a serum calcium being above 22 mg/dl, normal renal function, normal total protein, albumin, ACE levels, clear urine with no albuminuria, low
…show more content…
24-hour urine collection revealed proteinuria (550 mg). A peripheral blood smear revealed rouleaux formation. CT scans of the chest, abdomen and pelvis revealed no obvious malignancy. Quantitative immunoglobulins were significant for elevated IgA (2415 mg/dl) and concurrent suppression of IgG and IgM levels. Quantitative serum light chain measurement revealed normal levels of kappa and lambda, with an elevated Kappa:Lambda ratio at 2:1. SPEP, UPEP, and serum immunofixation revealed IgA-Kappa Multiple Myeloma (MM). Given her significant-severe, symptomatic hypercalcemia; she was treated with aggressive intravenous crystalloids and loop diuretics, calcitonin, pamidronate; and a decision to perform early hemodialysis given her extremely high calcium levels. Her calcium subsequently normalized to 10.1 mg/dl. Bone-marrow biopsy with flow cytometry revealed intracytoplasmic kappa-restricted monoclonal plasma cells that occupied 40% of the marrow. Bone survey was negative for lytic lesions. Oncology started her on a chemotherapeutic regimen consisting of Bortezomib, Lenalidomide, dexamethasone along
We will be hosting our annual Flu Shot clinic on Wednesday, October 19th from 9:30am – 1pm. If you are interested in receiving a free flu shot please message Matthew to sign up for a time slot. Space is limited.
Ct returned from JPS with documentation stating to be diagnosed with Type B Influenza. Ct was removed form his Bunk - 112/63 per CD and moved upstairs to a single room - 224. Ct was issued new linen, towels, washcloths, water bottles, Clorox wipes, disinfectant, a roll of toilet paper, and was instructed to stay in his room until further instructions. Due to Ct's Flu diagnosis, Ct will have to have his meal(s) delivered to his room by the scheduled FMs.
Scenario: John is a 4 year-old boy who was admitted for chemotherapy following diagnosis of acute lymphoblastic leukemia (ALL). He had a white blood cell count of 250,000. Clinical presentation included loss of appetite, easily bruised, gum bleeding, and fatigue. Physical examination revealed marked splenomegaly, pale skin color, temperature of 102°F, and upper abdomen tenderness along with nonspecific arthralgia.
Illnesses have long haunted the human race. As long as these illnesses have existed, humans have developed ways to cure themselves, beginning with simple herbs and proceeding as far as vaccines and complex medicines. One cure that long eluded scientists was that of the influenza virus. Now, the influenza vaccine, or flu shot, saves thousands of lives a year and helps prevent serious complications resulting from influenza infection.
There are often no symptoms in the early stages of myeloma. In some cases, myeloma may be exposed by an accident in the course of routine blood testing and if symptoms are present they may be indistinct and related to those of other medical conditions.
Usually, vaccinated children get sick after vaccination. This is because the flu virus has entered their bodies and sensitizes it against it. And, what’s more, the flu shot actually causes immunosuppression-weakened immunity.
Have you ever been in pain to where you feel like your whole body is aching along with a headache? Then, oddly your body temperature changes. One minute your hot then the next you're cold. Some people even have scratchy throats and a mild cough. Well all of these are signs that you might be coming down with the flu. This harsh and dreadful symptoms can be prevented by simply getting an influenza vaccination. To promote people getting the vaccine the government makes several ads a year to raise awareness to encourage people to make the responsible decision by getting the vaccination.
Health care workers are required to maintain immunizations and screenings for infections as needed. Keough compares the mandates of immunization to hand washing, stating that both help reduce and prevent the spread of infections. Implementation of immunization is to protect patients, the workers, and family members. The state of Rhode Island requires their health care workers to receive the influenza vaccination or wear a mask while providing care to patients; however, some worker may be exempt from the requirement. The health care worker must provide a valid explanation to be excused; however, a fine may be issued along with penalization of the worker.
When people see or hear advertisements, whether it be in a magazine or on television, many do not stop to consider or analyze the techniques that go into making the advertisement effective. For instance, the Center for Disease Control has a campaign that has the purpose of promoting the influenza vaccination. If you examine the campaign closely, it becomes clear that the advertising campaign targets a diverse audience of all ages, genders, and races who could all benefit from getting an influenza vaccination. In this advertisement campaign, the Center for Disease Control effectively promotes the benefits of getting an influenza vaccination to a targeted audience using numerous persuasive techniques such as association and universal appeal.
Many infectious diseases that once quickly spread and easily killed have been controlled or eradicated due to vaccinations. The efficacy of vaccines in reducing morbidity and mortality, particularly in children, is undeniable. Per the World Health Organization, childhood vaccinations prevent approximately 2-3 million deaths per year worldwide (WHO, 2016). In the United States, the value of immunizations is clearly displayed by comparing pre-vaccine era morbidity/mortality rates to post-vaccine era in regards to vaccine-preventable diseases. For example, prior to the diphtheria vaccine in the 1920’s, 206,000 people annually contracted the disease resulting in 15,520 deaths (History of Vaccines, 2009). However, between 2004 and 2014, only
Pneumococcal and influenza vaccination are among one of the measures that can reduce the risk of otitis media (4). The major aim of introduction of vaccine in immunization program is to prevent diseases caused by Streptococcus pneumoniae. This is because the effectiveness in the use of antibiotic and other drugs was reduced due to drug resistance strains. There are two types of vaccine recommended for effective prevention of pneumococcal diseases. These vaccines are pneumococcal conjugate and pneumococcal polysaccharide vaccine. Pneumococcal conjugate vaccine is approved for three classes of individuals: children younger than 2 years, children > 2 years to 64 years with medical indication and all adults 65 years and older.
Every year, millions of people start talking about the influenza virus and getting their vaccines as the flu season approaches, which starts around the October-November period and reaches its peak between December and March. Therefore, public health officials around the world- and in the U.S in particular- are constantly challenged by properly preparing for the annual influenza dilemma, given that this viruses, and other respiratory viruses, are a serious health threat to the U.S population and the world as a whole. Furthermore, what makes the influenza virus even more challenging to control is that it can mutate rapidly and reassort to form new strains, having the ability to reside in multiple animal hosts. In fact, many scientists and researchers have been doing in-depth intensive research so as to understand the mechanism behind this unique characteristic of the virus, try to find new ways to control it, and explore different areas of protection and vaccination.
The diagnosis of multiple myeloma can occur after a routine blood test with your doctor. However, the most common diagnosis occurs when doctors take an x-ray of a broken bone and suspect the cancer has caused or is a contributing factor to the broken bone. When analyzing the blood tests, the following are considered when diagnosing multiple myeloma: people with multiple myeloma have high levels of proteins in the blood, especially M and other immunoglobulin, albumin, and beta-2-microglobulin. Also, the blood exam tests for high levels of calcium and for creatinine levels (to assure that the kidneys are working properly).3 Other ways to test for multiple myeloma include urine tests, x-rays, biopsies (test the bone marrow itself from a large bone - a painful procedure). Unfortunately, Multiple myeloma is a very fatal cancer, where only 35% of patients diagnosed with multiple myeloma living 5 years past their diagnosis.3
Influenza is an infectious illness that can be spread from one individual to the next. It can be transmitted by means of saliva, nasal secretions, feces and blood. It can also be spread by coming in contact with the virus on contaminated surfaces. Influenza is responsible for an average of 36,000 deaths and for more than 226,000 hospitalizations each year in the United States. (Davidson, 2007-2009, Davis, 2007).
This paper explores published works related to patients who received the flu vaccine who were sixty-five years and older. The evaluated articles examine the effectiveness the flu vaccine had on the patient population of sixty-five years and older in relation to avoiding the flu and pneumonia diseases and hospitalizations, in this group of patients. It has been conceded for years that senior adults age sixty-five and older are at greater risk from an influenza illness and pneumonia than a vigorous young adult. It has been projected that between 71 percent and 85 percent of seasonal flu-related loss of life have happened in people sixty-five years and older and between 54 percent and 70 percent of seasonal