Erectile Dysfunction Associated With Bortezomib Treatment in a Patient With Multiple Myeloma and Amyloidosis

Abstract

Case Report Peripheral neuropathy (PN) is the dose-limiting toxicity of bortezomib, a reversible selective proteasome inhibitor approved for the treatment of MM. The incidence of new or worsening bortezomibinduced PN in untreated and relapsed or refractory MM is 44% and 36%, respectively, with Grade 3–4 neuropathy occurring in up to 15% of patients. Bortezomib-induced PN (BiPN) is most commonly sensory and although less frequent, motor PN has been eported, including life-threatening motor neurotoxicity. Still less ommon is autonomic neuropathy, including cutaneous hyperemia, ostural hypotension, paralytic ileus, abdominal distention, and uriary retention. We herein present the first detailed report of a patient with MM who developed erectile dysfunction (ED) after bortezomib treatment. A 60-year-old man without significant past medical history was found during a routine dental workup to have prolonged bleeding, with laboratory tests revealing iron deficiency with mild anemia and a protein gap. Work-up revealed asymptomatic IgG MM. Though a fat pad aspiration was positive for amyloidosis, biopsies taken during esophagogastroduodenoscopy and colonoscopy were Congo Red negative. Despite resolution of iron deficiency with iron