Smoldering Multiple Myeloma Presenting as Immune Thrombocytopenia
Correspondence
First Online:
Dear Editor,
Cytopenias associated with plasma cell dyscrasia are usually either disease-related (replacement of marrow hematopoiesis by clonal plasma cells) or therapy-related. Autoimmune cytopenias in association with plasma cell neoplasms are uncommon [1].
A 57-year-old lady presented to our hospital with a one-week history of generalized bluish spots over the body. History was negative for fever, oral ulcers, drug intake or autoimmune symptoms. No such previous episodes were elicited on history. Examination was unremarkable, except for the presence of multiple ecchymotic patches over arms and legs. Blood investigations were: hemoglobin-11 g/dl, white cell counts-7.33 × 10
9/L, and platelets-2 × 10
9/L. Peripheral smear showed normocytic normochromic red cells, marked thrombocytopenia and occasional large platelets. Blood chemistries were: serum calcium-9.2 mg/dl (8.5–10.1 mg/dl), protein-7.0 g/dl (6.4–8.2 g/dl), albumin-4.3 g/l (3.4–5.0 g/dl), creatinine-0.8 mg/dl (0.6–1.1 mg/dl),...
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The authors declare that there are no conflicts of interests.
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The authors state that an informed and written consent was obtained from the patient prior to the publication.
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References
- 1.Shimanovsky A, Alvarez Argote J, Murali S, Dasanu CA (2016) Autoimmune manifestations in patients with multiple myeloma and monoclonal gammopathy of undetermined significance. BBA Clin 25(6):12–18CrossRefGoogle Scholar
- 2.Faller E, Chapman L, Enright H, Browne P, McHugh J, Desmond R (2016) Immune thrombocytopenia purpura associated with multiple myeloma. Ann Hematol 95:1371–1372CrossRefGoogle Scholar
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