Necrotizing Enterocolitis in a Patient With Newly Diagnosed Multiple Myeloma and Hyperviscosity Syndrome: A Case...

Multiple myeloma (MM) is a clonal plasma cell proliferative disorder characterized by the abnormal increase of monoclonal paraprotein and can lead to specific end-organ damage. Necrotizing enterocolitis or bowel necrosis is a surgical emergency defined by cellular death because of reduced blood flow to the gastrointestinal tract. We report a case of a 75-year-old female who was diagnosed with hyperviscosity syndrome (HVS) and was sent to ED. Further workup showed that she had a new diagnosis of IgG kappa MM for which she was started on chemotherapy. Later, she developed respiratory distress and abdomen distention with less frequent bowel movements, and general surgery was consulted. CT scan of the abdomen and pelvis with contrast showed findings consistent with bowel ischemia vs infarction. The patient was immediately taken to the operating room, and exploratory laparotomy showed nonsurvivable bowel necrosis. She was transitioned to comfort care and passed away later. We aim to increase awareness among physicians to include HVS as one of the possible complications of MM and to detect it early to prevent morbidity and mortality.