Description
A 59 year old Asian female presented with a 3 month history of back pain. A skeletal survey showed wedging of her thoraco-lumbar vertebrae and lytic lesions in her skull bones. The serum creatinine was 330 ?ol/L and serum calcium 2.81 mmol/L. Serum parathyroid hormone was undetectable suggesting tumour-related hypercalcaemia. The diagnosis of multiple myeloma was confirmed by the presence of an lgA kappa paraprotein of 23 g/L, Bence – Jones proteinuria of 470 mg/L and a plasma cell count greater than 50% of all cells in a bone marrow aspirate and trephine.
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