Rahman Sabih, Veeraballi Sindhusha, Chan Kok Hoe, Shaaban Hamid S
Internal Medicine, Saint Michael's Medical Center, Newark, USA.
Medical Education, Saint Michael's Medical Center, Newark, USA.
Cureus. 2021 Mar 19;13(3):e13990. doi: 10.7759/cureus.13990.
Multiple myeloma is a neoplastic disorder of plasma cells. An abnormal coagulation profile, though commonly seen in multiple myeloma, can rarely manifest as life-threatening hemorrhagic complications. Bleeding tendencies in multiple myeloma can be explained by a variety of mechanisms such as dysfibrinogenemia, paraprotein-induced platelet dysfunction, shortened platelet survival, damage to the vascular endothelium, and acquired von-Willebrand syndrome. Herein, we report a 61-year-old female who presented with the signs and symptoms of hemorrhagic shock with multiple myeloma, which remained refractory to a massive transfusion protocol. Her condition stabilized when she was started on dexamethasone and antifibrinolytic infusion targeting acquired dysfibrinogenemia. To the best of our knowledge, hemorrhagic shock secondary to dysfibrinogenemia is an unusual phenomenon in multiple myeloma.
多发性骨髓瘤是一种浆细胞的肿瘤性疾病。异常的凝血指标虽然在多发性骨髓瘤中很常见，但很少表现为危及生命的出血并发症。多发性骨髓瘤的出血倾向可由多种机制解释，如异常纤维蛋白原血症、副蛋白诱导的血小板功能障碍、血小板存活时间缩短、血管内皮损伤以及获得性血管性血友病综合征。在此，我们报告一名61岁女性，她表现出多发性骨髓瘤伴出血性休克的症状和体征，对大量输血方案治疗无效。当开始使用地塞米松和针对获得性异常纤维蛋白原血症的抗纤溶药物输注时，她的病情得到了稳定。据我们所知，由异常纤维蛋白原血症继发的出血性休克在多发性骨髓瘤中是一种不寻常的现象。
