Acquired Coagulopathies Secondary to Plasma Cell Dyscrasias
A Report of Two Cases and Review of Literature
Keywords:
Bleeding, dysfunction, hemostatic, paraproteinemias, plasma cell dyscracias
Abstract
We report hemostatic dysfunction in two postmenopausal women presenting with mucosal bleeds secondary to plasma cell dyscrasias. The two postmenopausal women presented with complaints of mucosal bleeds like gum bleed and epistaxis. Peripheral smear examination showed rouleaux formation. After detailed haematological and coagulation work up, one patient was diagnosed as Waldenstro¨m macroglobulinemia (WM) with acquired vWD and impaired platelet function. The second patient was diagnosed as Multiple myeloma (MM) with acquired coagulopathy. Evaluation of elderly patients with bleeding manifestations should also include work up ruling out an acquired coagulation abnormality secondary to plasma cell dyscracia.References
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14. Eby C,Blinder M. Hemostatic complications associated with paraproteinemias. Current Hematology Reports.2003;2:388-394.
2. Kyrtsonis M, Vassilakopoulos T, Angelopuolou M, Siakantaris M, Pangalis G. Waldenstrom’s macroglobulinemia: clinical course and prognostic factors in 60 patients. Annals of Hematology. 2001; 80: 722–727
3. Mumford A, O’Donnell J, Gillmore J, Manning R, Hawkins P, Laffan M. Bleeding symptoms and coagulation abnormalities in 337 patients with Al-amyloidosis. Br J Haematol.2000;110: 454-460
4. Glaspy JA. Hemostatic abnormalities in multiple myeloma and related disorders. Hematol Oncol Clin North Am.1992; 6:1301-14
5. Gertz MA, Fonseca R, Rajkumar SV. Waldenstro¨m’s macroglobulinemia. Oncologist.2000;5:63–67
6. Perkins H, MacKenzie M, Fudenberg H. Hemostatic defects in dysproteinemias. Blood. 1970; 35:695–707.
7. Kyle, R. Multiple myeloma - Review of 869 cases. Mayo Clinic Proceedings 1975; 50: 29–39.
8. Kyle R, Gertz M, Witzig T, Lust J, Lacy M, Greipp P. Review of 1027 patients with newly diagnosed multiple myeloma. Mayo Clinic Proceedings 2003; 78: 21–33.
9. Rossi D, De Paoli L, Franceschetti S, Capello D, Vendramin C, Lunghi M, Conconi A, Magnani C, Gaidano G. Prevalence and clinical characteristics of immune thrombocytopenic purura in a cohort of monoclonal gammopathy of uncertain significance. Br J Haematol. 2006; 138: 249–252.
10. Federici AB, Rand JH, Bucciarelli P, Budde U, van Genderen PJ, Mohri H et al. Acquired von Willebrand syndrome: data from an international registry. Thromb Haemost. 2000;84:345-349
11. Franchini M, Lippi G. Acquired von Willebrand syndrome: an update. Am J Hematol. 2007;82:368-375.
12. Siaka C, Caron R, Goudemand J. A new ELISA assay for diagnosis of acquired von Willebrand Syndrome. Haemophilia. 2003;9:303-308.
13. Eby C.Bleeding and Thrombosis Risks in Plasma Cell Dyscrasias.Hematology 2007: 158-164
14. Eby C,Blinder M. Hemostatic complications associated with paraproteinemias. Current Hematology Reports.2003;2:388-394.
Published
2019-06-24
Issue
Section
Case Report
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