Abstract
Multiple myeloma can have different clinical manifestations, and not all patients present with classic CRAB component. We describe a 46-year-old woman admitted to our hospital with a complaint of a bluish-to-black discoloration of the second toe that was rapidly progressive and acute kidney injury. We documented a Kappa light chain monoclonal gammopathy, increased presence of plasmacytes in bone marrow aspiration, and multiple lytic bone lesions, which led to a diagnosis of multiple myeloma. Although multiple myeloma presenting with blue finger syndrome is uncommon, it must always be considered as a differential diagnosis with this clinical finding.
Highlights
Multiple myeloma can have different clinical manifestations, and not all patients present with a classical CRAB component: anemia, hypercalcemia, osteolytic lesions, and kidney injury [1].Kidney involvement is a usual characteristic of multiple myeloma in association with anemia or hypercalcemia and with evidence of mono or polyclonal gammopathy in protein electrophoresis [2]. e presentation of a blue digit as a manifestation of multiple myeloma is uncommon
We describe the case of a patient who was admitted because of a blue finger syndrome that was widely studied, until determining that her causative disease was multiple myeloma
Given the presence of monoclonal gammopathy of Kappa light chains, acute kidney injury, increased presence of plasmacytes in bone marrow aspirate, and multiple lytic bone lesions, the patient was given the diagnosis of multiple myeloma and was started on plasmapheresis and chemotherapy based on cyclophosphamide, bortezomib, and dexamethasone
Summary
Multiple myeloma can have different clinical manifestations, and not all patients present with a classical CRAB component: anemia, hypercalcemia, osteolytic lesions, and kidney injury [1]. Kidney involvement is a usual characteristic of multiple myeloma in association with anemia or hypercalcemia and with evidence of mono (majority of cases) or polyclonal gammopathy in protein electrophoresis [2]. E presentation of a blue digit as a manifestation of multiple myeloma is uncommon. Vasculitis is the underlying disease [3]. We describe the case of a patient who was admitted because of a blue finger syndrome that was widely studied, until determining that her causative disease was multiple myeloma
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