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A Rare Case of Multiple Myeloma Presenting as Evan’s Syndrome
Multiple myeloma is defined as the neoplastic proliferation of plasma cells resulting in a monoclonal gammopathy. The classic presentation of a patient is someone who presents with bone pain, osteopenia, or new onset fractures. We present a case of multiple myeloma presenting as Evan’s syndrome (ES)...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6573156/ https://www.ncbi.nlm.nih.gov/pubmed/31195829 http://dx.doi.org/10.1177/2324709619852760 |
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author | Karapetians, Anthony Bajaj, Tushar Valdes, Amanda Heidari, Arash |
author_facet | Karapetians, Anthony Bajaj, Tushar Valdes, Amanda Heidari, Arash |
author_sort | Karapetians, Anthony |
collection | PubMed |
description | Multiple myeloma is defined as the neoplastic proliferation of plasma cells resulting in a monoclonal gammopathy. The classic presentation of a patient is someone who presents with bone pain, osteopenia, or new onset fractures. We present a case of multiple myeloma presenting as Evan’s syndrome (ES). Evan’s syndrome is autoimmune hemolytic anaemia with autoimmune thrombocytopenia. A 44-year-old female was referred from her primary physician to the hospital as laboratory testing revealed haemoglobin of 5 gm/dL. The patient reported a two-month history of fatigue and a sixty-pound weight loss. Laboratory results demonstrated autoimmune hemolytic anaemia, C3 positivity, elevated immunoglobulin (Ig)G, elevated lactate dehydrogenase (LDH), low haptoglobin, elevated reticulocyte count, elevated RDW-CV (red blood cell distribution width-corpuscular volume), positive direct Coombs test, thrombocytopenia, and proteinuria, all of which led to an underlying ES. The patient was started on intravenous steroids followed by oral steroids. A flow cytometry, serum protein electrophoresis, and cytogenetics were obtained. A bone marrow biopsy revealed multiple myeloma and she was started on Bortezomib treatment. We present the fifth reported case of Evan’s syndrome and multiple myeloma. |
format | Online Article Text |
id | pubmed-6573156 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-65731562019-06-24 A Rare Case of Multiple Myeloma Presenting as Evan’s Syndrome Karapetians, Anthony Bajaj, Tushar Valdes, Amanda Heidari, Arash J Investig Med High Impact Case Rep Case Report Multiple myeloma is defined as the neoplastic proliferation of plasma cells resulting in a monoclonal gammopathy. The classic presentation of a patient is someone who presents with bone pain, osteopenia, or new onset fractures. We present a case of multiple myeloma presenting as Evan’s syndrome (ES). Evan’s syndrome is autoimmune hemolytic anaemia with autoimmune thrombocytopenia. A 44-year-old female was referred from her primary physician to the hospital as laboratory testing revealed haemoglobin of 5 gm/dL. The patient reported a two-month history of fatigue and a sixty-pound weight loss. Laboratory results demonstrated autoimmune hemolytic anaemia, C3 positivity, elevated immunoglobulin (Ig)G, elevated lactate dehydrogenase (LDH), low haptoglobin, elevated reticulocyte count, elevated RDW-CV (red blood cell distribution width-corpuscular volume), positive direct Coombs test, thrombocytopenia, and proteinuria, all of which led to an underlying ES. The patient was started on intravenous steroids followed by oral steroids. A flow cytometry, serum protein electrophoresis, and cytogenetics were obtained. A bone marrow biopsy revealed multiple myeloma and she was started on Bortezomib treatment. We present the fifth reported case of Evan’s syndrome and multiple myeloma. SAGE Publications 2019-06-14 /pmc/articles/PMC6573156/ /pubmed/31195829 http://dx.doi.org/10.1177/2324709619852760 Text en © 2019 American Federation for Medical Research http://creativecommons.org/licenses/by/4.0/ This article is distributed under the terms of the Creative Commons Attribution 4.0 License (http://www.creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Case Report Karapetians, Anthony Bajaj, Tushar Valdes, Amanda Heidari, Arash A Rare Case of Multiple Myeloma Presenting as Evan’s Syndrome |
title | A Rare Case of Multiple Myeloma Presenting as Evan’s Syndrome |
title_full | A Rare Case of Multiple Myeloma Presenting as Evan’s Syndrome |
title_fullStr | A Rare Case of Multiple Myeloma Presenting as Evan’s Syndrome |
title_full_unstemmed | A Rare Case of Multiple Myeloma Presenting as Evan’s Syndrome |
title_short | A Rare Case of Multiple Myeloma Presenting as Evan’s Syndrome |
title_sort | rare case of multiple myeloma presenting as evan’s syndrome |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6573156/ https://www.ncbi.nlm.nih.gov/pubmed/31195829 http://dx.doi.org/10.1177/2324709619852760 |
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