Case Report

Unconventional Presentation of Multiple Myeloma: A Case Study

Anum Abbas
Bahawal Victoria Hospital Bahawalpur
Urwa Rasool
Bahawal Victoria Hospital Bahawalpur

✉ Correspondence: Anum Abbas Email: anumabbas687@gmail.com

DOI https://doi.org/10.70302/jpsim.v7i1.2617
Volume: 7, Issue 1 Pages: 81–83 Published: 10 Mar 2026
Received: 13 Dec 2025 Revised: 15 Jan 2026 Accepted: 19 Feb 2026 Published Online: 10 Mar 2026

Abstract

Multiple myeloma (MM) is a hematologic malignancy characterized by the clonal proliferation of plasma cells within the bone marrow, often presenting with classic symptoms such as bone pain, anemia, hypercalcemia, renal dysfunction, and recurrent infections. As the second most common blood cancer, it represents about 1% of all cancer cases, contributes to 2% of cancer-related deaths, and comprises 12–15% of oncological and hematological disorders. . Renal failure is a significant concern for multiple myeloma patients, often stemming from tubulointerstitial pathology caused by high levels of circulating monoclonal immunoglobulin free light chains. These proteins can induce kidney problems including proximal tubule cell toxicity, tubulointerstitial nephritis, and myeloma kidney (cast nephropathy). Less frequently, elevated free light chains may lead to conditions like immunoglobulin light chain amyloidosis and light chain deposition disease, which typically exhibit a slow progression of renal failure rather than acute injury. early diagnosis and appropriate treatment is crucial. This case presents an unusual presentation of multiple myeloma, resulting in a delay in both diagnosis and treatment initiation. It is crucial for clinicians to persist in reporting unusual presentations of multiple myeloma and to view it as a potential diagnosis in patients exhibiting serious and uncommon symptoms.

Keywords
multiple myeloma myeloma cast nephropathy immunoglobulin light chains hypercalcemia smoldering multiple myeloma

How to Cite This Article

Abbas A, Rasool U. Unconventional Presentation of Multiple Myeloma: A Case Study. J Pak Soc Intern Med. 2026;7(1):81–83. doi:10.70302/jpsim.v7i1.2617

Conflict of Interest

All authors declare no competing interests.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

No specific funding was received for this research.

Funder information follows the Crossref Funder Registry standard.

References

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Reference list indexed for Google Scholar and ResearchGate. DOI links resolve via doi.org.

CC BY CC BY 4.0 This article is published under the Creative Commons Attribution 4.0 International License. May be shared and adapted with attribution. © 2026 Journal of Pakistan Society of Internal Medicine.
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