Marked plasmacytosis and immunoglobulin abnormalities following infusion of streptokinase

Marked plasmacytosis is an uncommon clinical finding associated with plasma cell dyscrasias and certain reactive states, particularly serum sickness. Moreover, serum sickness-like reactions are a well-recognized complication of therapy with streptokinase. In this report, the authors describe a patient who developed a transient, but striking, plasmacytosis and an unexplained fever following streptokinase treatment for a pulmonary embolus. An evaluation for multiple myeloma was completely negative except for the occurrence of serum monoclonal-like proteins which largely disappeared over an eight month period.