Acquired factor X deficiency in a multiple myeloma without amyloidosis: a case report

Acta Clin Belg. 2023 Dec;78(6):524-528. doi: 10.1080/17843286.2023.2265650. Epub 2023 Oct 16.

Abstract

Background: Multiple myeloma is one of the most common hematologic malignancies. Acquired factor X deficiencies are often observed in primary (AL) amyloidosis and rarely in multiple myeloma.

Objective: We report a case of an acquired factor X deficiency in a patient with a newly diagnosed IgA lambda multiple myeloma, without any evidence of concomitant amyloidosis.

Methods: We present the patient's medical history, clinical and physical examinations, laboratory analysis, and outcome.

Results: A 76-year-old male presented at the emergency department with ongoing gingival bleeding. Several analytical problems with blood sample analysis arose, which eventually led to the diagnosis of a multiple myeloma. Further exploration revealed an acquired factor X deficiency, explaining the ongoing bleeding. There was no evidence of concomitant amyloidosis. The multiple myeloma was treated, leading to complete remission of the malignancy and bleeding tendency.

Conclusion: While coagulopathy is rarely observed in patients diagnosed with multiple myeloma, considering an acquired factor X deficiency becomes relevant when such patient present with bleeding diathesis.

Keywords: Multiple myeloma; factor X deficiency; without amyloidosis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Amyloidosis* / complications
  • Amyloidosis* / diagnosis
  • Factor X Deficiency* / complications
  • Factor X Deficiency* / diagnosis
  • Humans
  • Male
  • Multiple Myeloma* / complications
  • Multiple Myeloma* / diagnosis