PT  - JOURNAL ARTICLE
AU  - Namrah Siddiq
AU  - Colin Bergstrom
AU  - Larry D Anderson, Jr
AU  - Srikanth Nagalla
TI  - Bleeding due to acquired dysfibrinogenemia as the initial presentation of multiple myeloma
AID  - 10.1136/bcr-2019-229312
DP  - 2019 Jul 01
TA  - BMJ Case Reports
PG  - e229312
VI  - 12
IP  - 7
4099  - http://casereports.bmj.com/content/12/7/e229312.short
4100  - http://casereports.bmj.com/content/12/7/e229312.full
SO  - BMJ Case Reports2019 Jul 01; 12
AB  - Patients with multiple myeloma (MM) are at risk for acquired dysfibrinogenemia resulting in laboratory abnormalities and/or bleeding complications. We describe a 63-year-old man who presented with bleeding diathesis in the presence of a low fibrinogen activity level with a normal fibrinogen antigen level. Further studies revealed elevated levels of lambda free light chains, and he was diagnosed with MM. Despite initiating treatment with bortezomib/dexamethasone, he continued to have recurrent bleeds along with hypofibrinogenaemia, prompting a switch to carfilzomib/dexamethasone. The patient responded with improvement in bleeding symptoms, normalisation of fibrinogen activity and a decrease in serum free light chains.