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Case report
Acquired factor X deficiency in a patient with multiple myeloma: a rare case highlighting the significance of comprehensive evaluation and the need for antimyeloma therapy for bleeding diathesis
  1. Samuel Benjamin Reynolds1,
  2. Dhaval Pravinkumar Maghavani2 and
  3. Hamza Hashmi3
  1. 1 Department of Internal Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA
  2. 2 Department of Medicine, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
  3. 3 Division of Medical Oncology and Hematology, University of Louisville, Louisville, Kentucky, USA
  1. Correspondence to Dr Hamza Hashmi, hamzahashmi87{at}


Factor X deficiency is a rare bleeding disorder that can be associated with life-threatening bleeding events. Factor X deficiency can either be inherited or acquired. Acquired cases of factor X deficiency can be seen in patients with plasma cell dyscrasias as well as amyloidosis. Coagulopathy, with clinically relevant bleeding events, although rare, is not an unusual phenomenon for patients with systemic amyloidosis. However, clinically relevant bleeding in patients with symptomatic multiple myeloma, without associated amyloidosis, has not been reported in literature before. We present a rare case of multiple myeloma without concomitant amyloidosis that presented with life-threatening bleeding from acquired deficiency of factor X and responded remarkably to treatment for underlying multiple myeloma. This case not only highlights the diagnostic workup required in patients with factor X deficiency but also provides the principles of management of acquired coagulopathy in plasma cell dyscrasias.

  • chemotherapy
  • haematology (incl blood transfusion)

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  • Contributors SBR contributed towards data collection and manuscript writing. DPM contributed towards manuscript compilation. HH contributed towards data collection, manuscript writing and editing, manuscript submission and correspondence.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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