Persistent Mild Anemia and Hypercalcemia were Ignored as Normal Reaction Secondary to Oral Calcium Supplementation in a Steroid-Dependent Asthma Patient Ultimately Diagnosed as Multiple Myeloma: a Case Report and Literature Review

Clin Lab. 2019 May 1;65(5). doi: 10.7754/Clin.Lab.2018.181017.

Abstract

Background: Anemia can be secondary to many diseases and hypercalcemia can be secondary to oral calcium supplementation. For non-hematologists, anemia and hypercalcemia are usually ignored. Here we report a case of persistent mild anemia and hypercalcemia which were ignored as a normal reaction secondary to oral calcium supplementation in a steroid-dependent asthma patient; it was ultimately diagnosed as multiple myeloma.

Methods: Bone marrow puncture, combined serum, and urine laboratory indexes were performed for diagnosis.

Results: A bone marrow puncture specimen comprised 31.5% plasma cells. The serum and urine immunoelectrophoresis showed monoclonal kappa light chains.

Conclusions: When anemia and hypercalcemia occur in an elderly patient, physicians should pay attention to multiple myeloma, especially when accompanied with vertebral and flat bone fractures.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Anemia / diagnosis*
  • Anemia / etiology
  • Asthma / complications
  • Asthma / drug therapy*
  • Calcium / administration & dosage*
  • Calcium / adverse effects
  • Diagnosis, Differential
  • Dietary Supplements
  • Glucocorticoids / administration & dosage
  • Humans
  • Hypercalcemia / diagnosis*
  • Hypercalcemia / etiology
  • Male
  • Multiple Myeloma / complications
  • Multiple Myeloma / diagnosis*
  • Prednisone / administration & dosage*

Substances

  • Glucocorticoids
  • Calcium
  • Prednisone