Multiple myeloma in a patient with fever of unknown origin and cholestasis

Mumoli, Nicola; Cei, Marco; Incensati, Roberto; Verzuri, Serena
June 2004
CMAJ: Canadian Medical Association Journal;6/8/2004, Vol. 170 Issue 12, p1809
Academic Journal
THE DIFFERENTIAL DIAGNOSIS OF FEVER of unknown origin includes in-fectious diseases, malignancies and connective tissue diseases. Multiple myeloma is not usually included in the differential diag-nosis, nor is it considered a frequent cause of cholestasis in the absence of amyloidosis. We report a case of multiple myeloma in a patient presenting with a long-standing fever and cholestasis. The patient underwent a long and unfruitful series of diagnostic procedures, including liver biopsy. The clue to the diagnosis, es-tablished with a marrow biopsy, was the presence of a parapro-tein in the serum.


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