A case of acquired dysfibrinogenemia in multiple myeloma treated with therapeutic plasma exchange

Transfus Apher Sci. 2013 Feb;48(1):35-8. doi: 10.1016/j.transci.2012.06.021. Epub 2012 Jul 28.


A 70 year old Caucasian woman with IgG lamda multiple myeloma presented with uncontrollable bleeding from a bone marrow biopsy site which started days after the procedure. The patient was hyperviscous, and coagulation tests showed elevated activated partial thromboplastin time (aPTT) which was not corrected with a mixing study, elevated thrombin time and reptilase time, and possible inhibitors to Factors VIII and IX. Therapeutic plasma exchange was performed using plasma with corrections of plasma viscosity (1.6 to 1.1 centipoise) and aPTT (50 to 42.1s) observed. The bleeding was controlled, and purified IgG demonstrated dysfibrinogenemic effects of the patient's paraprotein.

Publication types

  • Case Reports

MeSH terms

  • Afibrinogenemia / therapy*
  • Aged
  • Female
  • Humans
  • Multiple Myeloma / blood*
  • Multiple Myeloma / therapy*
  • Plasma Exchange / methods*