, Volume 89, Issue 4, pp 419-420
Date: 18 Aug 2009

Treatment of multiple myeloma and arterial thrombosis

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Dear Editor,

In January, 2008, a 49-year-old woman presented at the emergency department of our hospital with a 2-week history of severe back pain. In three months, she had lost 10 kg in body weight. She also complained about constipation and upper abdominal pain after meals for several years. Her medical history included a popliteal artery stenosis, for which she had received conservative treatment, and Graves' disease, treated with radioactive iodine. Her only medication was levothyroxine. The patient had a smoking history of 20 pack years.

Physical examination was unremarkable apart from pain localised on the lower back when pressure was exerted. X-ray examination of skeletal structures revealed lumbar vertebrae fractures of L1, L2, and L3. Blood test results showed a hypercalcaemia of 3.24 mmol/L, C-reactive protein of 29 mg/L, haemoglobulin level of 9.7 mmol/L, mean cell volume of 110 fl, platelet count of 291 × 109/L and a leucocyte count of 6.4 × 109/L. Subsequently, tested protei