Case 22-1999

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Abstract
Presentation of CaseA 68-year-old woman with refractory multiple myeloma was admitted to the hospital because of pancytopenia with bleeding.Multiple myeloma had been diagnosed 10 years earlier but had not been treated until 7 years after the diagnosis, when the IgG level rose to 9270 mg per deciliter. Treatment with pulsed doses of dexamethasone resulted in a partial response. Seventeen months before admission, skeletal radiographs showed only osteopenia in the left hip. Radiographs of the lumbar spine, obtained eight months before admission because of low back pain, showed compression fractures of four vertebral bodies. Pneumonia developed in the same . . .

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