Combined Coagulopathy Can Induce Both Hemorrhagic and Thrombotic Complications in Multiple Myeloma

Intern Med. 2018 Nov 15;57(22):3303-3306. doi: 10.2169/internalmedicine.0915-18. Epub 2018 Jul 6.

Abstract

Coagulation abnormalities are a rare but critical complication associated with plasma cell diseases. We herein present a case of multiple myeloma (MM) with complicated coagulopathy. Initially, the patient showed severe bleeding tendency due to concomitant acquired hemophilia A and acquired von Willebrand syndrome. Interestingly, the patient also exhibited hyperactivation of factor IX. During treatment for MM, the bleeding complications were ameliorated; however, the patient had central retinal vein occlusion. All of the coagulation abnormalities were completely resolved after the complete remission of MM. This case suggests that MM patients may have concomitant risks for both bleeding and thromboembolic complications.

Keywords: acquired hemophilia A; acquired von Willebrand disease; multiple myeloma.

Publication types

  • Case Reports

MeSH terms

  • Female
  • Hemophilia A / complications*
  • Hemorrhage / etiology*
  • Humans
  • Male
  • Middle Aged
  • Multiple Myeloma / complications*
  • Thrombosis / complications*
  • von Willebrand Diseases / complications*

Supplementary concepts

  • Factor 8 deficiency, acquired