Lower Gastrointestinal Involvement in Multiple Myeloma: A Case Report
Abid M Sadiq1,2, Jamil M Suleiman1, Hassan S Vuai1
1Department of Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
International Medical Case Reports Journal
|September 14, 2020
Summary
Multiple myeloma can rarely cause gastrointestinal bleeding, indicating extramedullary disease. Early detection of this rare complication is crucial for potentially improving patient prognosis.
Area of Science:
- Hematology
- Gastroenterology
- Oncology
Background:
- Multiple myeloma (MM) typically presents with anemia and bone pain.
- Gastrointestinal (GI) tract involvement, particularly the lower GI tract, is an uncommon manifestation of MM.
- Extramedullary disease in MM is associated with a poorer prognosis.
Observation:
- An elderly male presented with anemia, thrombocytopenia, and positive stool occult blood, initially suspected as GI malignancy.
- Endoscopic findings were inconclusive, but elevated serum total protein, calcium, and creatinine raised suspicion for MM.
- The patient fulfilled the CRAB criteria (hypercalcemia, renal failure, anemia, lytic bone lesions) confirming the diagnosis of MM.
Findings:
- This case highlights a rare instance of multiple myeloma presenting with significant GI bleeding.
- The GI bleeding was attributed to extramedullary disease, a known indicator of advanced MM.
- The diagnostic challenge involved differentiating MM from primary GI malignancy.
Implications:
- Recognizing GI bleeding as a potential extramedullary manifestation of MM is critical for timely diagnosis.
- Early identification of MM-related GI bleeding may influence treatment strategies and prognostic outcomes.
- This case underscores the importance of considering systemic diseases like MM in patients with unexplained GI symptoms and bleeding.
