Pancytopenia in Multiple Myeloma- An Enigma: Our Experience from Tertiary Care Hospital
Published: November 1, 2015 | DOI: https://doi.org/10.7860/JCDR/2015/.6718
Hanaganahalli B Sridevi, Sharada Rai, Pooja K Suresh, Meludurgamutt S Somesh, Jessica Minal
1. Assistant Professor, Department of Pathology, Kasturba Medical College, Mangalore, Manipal University, India.
2. Associate Professor, Department of Pathology, Kasturba Medical College, Mangalore, Manipal University, India.
3. Assistant Professor, Department of Pathology, Kasturba Medical College, Mangalore, Manipal University, India.
4. Associate Professor, Department of Anatomy, Srinivas Institute of Medical Sciences & Research Centre, Mukka, Mangalore, India.
5. Assistant Professor, Department of Pathology, Kasturba Medical College, Mangalore, Manipal University, India.
Correspondence
Dr. Pooja K Suresh,
Assistant Professor, Department of Pathology, Kasturba Medical College, Light House Hill Road,
Manipal University, Mangalore 575001, India.
E-mail : puja4444@gmail.com
Introduction: Multiple myeloma is a plasma cell neoplasm that is characterized by clonal proliferation of malignant plasma cell in the bone marrow along with M-protein in the serum and/or urine. Pancytopenia as a initial presentation of multiple myeloma is quite unusual. We are presenting a case series having pancytopenia as the presenting complaint.
Materials and Methods: A retrospective study was conducted for a period of 30 months, wherein all the cases of multiple myeloma presenting with pancytopenia were included. The complete blood picture, peripheral smear examination, bone marrow aspirate & protein electrophoresis of all the cases were reviewed & analysed.
Results: During the study period, 10 cases presented with pancytopenia with a mean age of 66.3 years (range: 59-72 years) at presentation with male: female ratio being 8:2. Fatigue and weakness was the most common symptom (100%) & average ESR was 104 mm/hour. High-resolution serum electrophoresis, showed a dense, sharp to wide M band in the gamma globulin region. Bone marrow plasma cell percentage was increased with an average of 63.1%. Bone marrow biopsy correlation was obtained in 100% cases.
Conclusion: Diagnosing multiple myeloma, presenting as pancytopenia requires a high degree of suspicion to avoid delay in initiation of treatment.
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