Combined Coagulopathy Can Induce Both Hemorrhagic and Thrombotic Complications in Multiple Myeloma

Ichiro Kawashima; Katsuhiro Takano; Takuma Kumagai; Megumi Koshiishi; Saori Oishi; Yuki Sueki; Kei Nakajima; Toru Mitsumori; Keita Kirito

doi:10.2169/internalmedicine.0915-18

CASE REPORTS

Combined Coagulopathy Can Induce Both Hemorrhagic and Thrombotic Complications in Multiple Myeloma

Ichiro Kawashima, Katsuhiro Takano, Takuma Kumagai, Megumi Koshiishi, Saori Oishi, Yuki Sueki, Kei Nakajima, Toru Mitsumori, Keita Kirito

Author information

Ichiro Kawashima
Department of Hematology and Oncology, University of Yamanashi, Japan
Katsuhiro Takano
Clinical and Laboratory Medicine, University of Yamanashi, Japan
Takuma Kumagai
Department of Hematology and Oncology, University of Yamanashi, Japan
Megumi Koshiishi
Department of Hematology and Oncology, University of Yamanashi, Japan
Saori Oishi
Department of Hematology and Oncology, University of Yamanashi, Japan
Yuki Sueki
Department of Hematology and Oncology, University of Yamanashi, Japan
Kei Nakajima
Department of Hematology and Oncology, University of Yamanashi, Japan
Toru Mitsumori
Department of Hematology and Oncology, University of Yamanashi, Japan
Keita Kirito
Department of Hematology and Oncology, University of Yamanashi, Japan

Keywords: multiple myeloma, acquired von Willebrand disease, acquired hemophilia A

JOURNAL OPEN ACCESS

2018 Volume 57 Issue 22 Pages 3303-3306

DOI https://doi.org/10.2169/internalmedicine.0915-18

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Abstract

Coagulation abnormalities are a rare but critical complication associated with plasma cell diseases. We herein present a case of multiple myeloma (MM) with complicated coagulopathy. Initially, the patient showed severe bleeding tendency due to concomitant acquired hemophilia A and acquired von Willebrand syndrome. Interestingly, the patient also exhibited hyperactivation of factor IX. During treatment for MM, the bleeding complications were ameliorated; however, the patient had central retinal vein occlusion. All of the coagulation abnormalities were completely resolved after the complete remission of MM. This case suggests that MM patients may have concomitant risks for both bleeding and thromboembolic complications.

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