Abstract
A middle-aged man presented to the acute medical unit for progressive left facial swelling with a gingival mass and right eye visual loss with erythematous ocular swelling. Subsequently he developed upper gastrointestinal tract bleeding and passed melaena, requiring blood transfusion for resuscitation. Initial blood tests found leucocytosis with circulating plasmablasts, anaemia, acute kidney injury with elevated creatinine and hypercalcaemia. Further workups by immunofixation and flow cytometry revealed IgG-lambda paraprotein and a clonal plasma cell population with lambda light chain restriction in peripheral blood.
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