Department of Laboratory Medicine, AZ Damiaan, Oostende, Belgium.
Department of Laboratory Medicine, AZ Sint-Jan, Brugge, Belgium.
Acta Clin Belg. 2023 Dec;78(6):524-528. doi: 10.1080/17843286.2023.2265650. Epub 2023 Oct 16.
Multiple myeloma is one of the most common hematologic malignancies. Acquired factor X deficiencies are often observed in primary (AL) amyloidosis and rarely in multiple myeloma.
We report a case of an acquired factor X deficiency in a patient with a newly diagnosed IgA lambda multiple myeloma, without any evidence of concomitant amyloidosis.
We present the patient's medical history, clinical and physical examinations, laboratory analysis, and outcome.
A 76-year-old male presented at the emergency department with ongoing gingival bleeding. Several analytical problems with blood sample analysis arose, which eventually led to the diagnosis of a multiple myeloma. Further exploration revealed an acquired factor X deficiency, explaining the ongoing bleeding. There was no evidence of concomitant amyloidosis. The multiple myeloma was treated, leading to complete remission of the malignancy and bleeding tendency.
While coagulopathy is rarely observed in patients diagnosed with multiple myeloma, considering an acquired factor X deficiency becomes relevant when such patient present with bleeding diathesis.
多发性骨髓瘤是最常见的血液系统恶性肿瘤之一。获得性因子 X 缺乏症在原发性（AL）淀粉样变性中经常观察到，在多发性骨髓瘤中很少见。
我们报告了一例新诊断的 IgA λ 型多发性骨髓瘤患者中出现获得性因子 X 缺乏症的病例，无同时存在淀粉样变性的证据。
我们介绍了患者的病史、临床和体格检查、实验室分析和结果。
一名 76 岁男性因持续牙龈出血到急诊就诊。血液样本分析出现了多个分析问题，最终导致多发性骨髓瘤的诊断。进一步的探索揭示了获得性因子 X 缺乏症，解释了持续的出血。没有同时存在淀粉样变性的证据。多发性骨髓瘤得到治疗，导致恶性肿瘤和出血倾向完全缓解。
虽然在诊断为多发性骨髓瘤的患者中很少观察到凝血功能障碍，但当此类患者出现出血倾向时，考虑获得性因子 X 缺乏症变得相关。
