Bleeding due to acquired dysfibrinogenemia as the initial presentation of multiple myeloma

Namrah Siddiq; Colin Bergstrom; Larry D. Anderson; Srikanth Nagalla

doi:10.1136/bcr-2019-229312

Bleeding due to acquired dysfibrinogenemia as the initial presentation of multiple myeloma

Namrah Siddiq, Colin Bergstrom, Larry D. Anderson, Srikanth Nagalla

Research output: Contribution to journal › Article › peer-review

5 Scopus citations

Abstract

Patients with multiple myeloma (MM) are at risk for acquired dysfibrinogenemia resulting in laboratory abnormalities and/or bleeding complications. We describe a 63-year-old man who presented with bleeding diathesis in the presence of a low fibrinogen activity level with a normal fibrinogen antigen level. Further studies revealed elevated levels of lambda free light chains, and he was diagnosed with MM. Despite initiating treatment with bortezomib/dexamethasone, he continued to have recurrent bleeds along with hypofibrinogenaemia, prompting a switch to carfilzomib/dexamethasone. The patient responded with improvement in bleeding symptoms, normalisation of fibrinogen activity and a decrease in serum free light chains.

Original language	English (US)
Article number	e229312
Journal	BMJ Case Reports
Volume	12
Issue number	7
DOIs	https://doi.org/10.1136/bcr-2019-229312
State	Published - Jul 1 2019

Keywords

cancer intervention
chemotherapy
haematology (incl blood transfusion)
malignant and benign haematology

ASJC Scopus subject areas

General Medicine

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10.1136/bcr-2019-229312

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title = "Bleeding due to acquired dysfibrinogenemia as the initial presentation of multiple myeloma",

abstract = "Patients with multiple myeloma (MM) are at risk for acquired dysfibrinogenemia resulting in laboratory abnormalities and/or bleeding complications. We describe a 63-year-old man who presented with bleeding diathesis in the presence of a low fibrinogen activity level with a normal fibrinogen antigen level. Further studies revealed elevated levels of lambda free light chains, and he was diagnosed with MM. Despite initiating treatment with bortezomib/dexamethasone, he continued to have recurrent bleeds along with hypofibrinogenaemia, prompting a switch to carfilzomib/dexamethasone. The patient responded with improvement in bleeding symptoms, normalisation of fibrinogen activity and a decrease in serum free light chains.",

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T1 - Bleeding due to acquired dysfibrinogenemia as the initial presentation of multiple myeloma

AU - Siddiq, Namrah

AU - Bergstrom, Colin

AU - Anderson, Larry D.

AU - Nagalla, Srikanth

PY - 2019/7/1

Y1 - 2019/7/1

N2 - Patients with multiple myeloma (MM) are at risk for acquired dysfibrinogenemia resulting in laboratory abnormalities and/or bleeding complications. We describe a 63-year-old man who presented with bleeding diathesis in the presence of a low fibrinogen activity level with a normal fibrinogen antigen level. Further studies revealed elevated levels of lambda free light chains, and he was diagnosed with MM. Despite initiating treatment with bortezomib/dexamethasone, he continued to have recurrent bleeds along with hypofibrinogenaemia, prompting a switch to carfilzomib/dexamethasone. The patient responded with improvement in bleeding symptoms, normalisation of fibrinogen activity and a decrease in serum free light chains.

AB - Patients with multiple myeloma (MM) are at risk for acquired dysfibrinogenemia resulting in laboratory abnormalities and/or bleeding complications. We describe a 63-year-old man who presented with bleeding diathesis in the presence of a low fibrinogen activity level with a normal fibrinogen antigen level. Further studies revealed elevated levels of lambda free light chains, and he was diagnosed with MM. Despite initiating treatment with bortezomib/dexamethasone, he continued to have recurrent bleeds along with hypofibrinogenaemia, prompting a switch to carfilzomib/dexamethasone. The patient responded with improvement in bleeding symptoms, normalisation of fibrinogen activity and a decrease in serum free light chains.

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KW - chemotherapy

KW - haematology (incl blood transfusion)

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Bleeding due to acquired dysfibrinogenemia as the initial presentation of multiple myeloma

Abstract

Keywords

ASJC Scopus subject areas

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