AB0622 WHEN OSTEOPOROSIS, COELIAC DISEASE AND MULTIPLE MYELOMA CO-EXIST

Background: Secondary causes of bone loss are sometimes overlooked in patients who diagnosed as having osteoporosis. This is especially true if more than one risk factor for secondary osteoporosis present, with clinicians focusing on the common cause. Here we present a case caused by coeliac disease and multiple myeloma. Objectives: should be suspected very low mineral density those no obvious factors. Comprehensive examination investigations must done to look all because sometimes, seen our patient, you may find one. Methods: A 74 year old gentleman presented rheumatology clinic assessment He had been recently disease. DXA scan showed T score -3.5 at lumbar spine, -2.5 left hip Z -2.9. not sustained any fractures past. There was history corticosteroid exposure parental fracture or drank up 21 units alcohol week an ex-smoker. managing gluten-free diet. His testosterone vitamin D levels were normal. Serum electrophoresis, part workup, revealed diagnosis then developed back pain given his new myeloma, prompt carried out. skeletal survey T7 subsequent MRI impending cord compression, which treated successfully radiotherapy. underwent chemotherapy autologous stem cell transplantation OGD following post gluten rechallenge after established free biopsy shows evidence Interestingly, did only treat patient’s but also Results: Z-score useful indicator possible ?2.0 less below expected range age careful scrutiny underlying Coeliac gluten-sensitive enteropathy known cause It likely hyperparathyroidism from deficiency. Multiple myeloma aging adults resulting osteolytic and/or osteoporotic through increased resorption decreased formation pro-inflammatory cytokines. While malignancies, association rare, has described. Conclusion: highlights importance evaluating often, contributory factor. that could help identify would benefit thorough examination. References: [1]Sahin, Idris & Demir, Cengiz Alay, Murat Eminbeyli, Lokman. (2011). The Patient Presenting Renal Failure Due Myeloma Associated Celiac Disease: Case Report. UHOD - Uluslararasi Hematoloji-Onkoloji Dergisi. 21. 10.4999/uhod.09087. [2]?pek, Belkiz Aksungar, Fehime Tiftikci, Arzu Coskun, Abdurrahman Serteser, Mustafa Unsal, Ibrahim. (2016). rare association: celiac asymptomatic young patient. Turkish Journal Biochemistry. 41. 10.1515/tjb-2016-0053. [3]Swaminathan K, Flynn R, Garton M, Paterson C, Leese G. Search osteoporosis: scores predictors? Postgrad Med J. 2009 Jan;85(999):38-9. doi: 10.1136/pgmj.2007.065748. PMID: 19240287. Disclosure Interests: None declared.