Waldenstrom's Macroglobulinemia and Peripheral Neuropathy, Organomegaly, Endocrinopathy, Monoclonal Gammopathy, and Skin Changes with a Bleeding Diathesis and Rash

S Haider; T Latif; A Hochhausler; F Lucas; N Abdel Karim

doi:10.1155/2013/890864

Waldenstrom's Macroglobulinemia and Peripheral Neuropathy, Organomegaly, Endocrinopathy, Monoclonal Gammopathy, and Skin Changes with a Bleeding Diathesis and Rash

Case Rep Oncol Med. 2013:2013:890864. doi: 10.1155/2013/890864. Epub 2013 Dec 25.

Authors

S Haider¹, T Latif², A Hochhausler¹, F Lucas³, N Abdel Karim²

Affiliations

¹ Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA.
² Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA ; Division of Hematology and Oncology, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA.
³ Department of Pathology, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA.

Abstract

We report a case of a 29-year-old male who presented with paraesthesia and skin lesions with excessive bleeding after skin biopsy leading to hematology consultation. He was found to have prolonged partial thromboplastin time (PTT) and monoclonal gammopathy on serum protein electrophoresis (SPEP). He experienced excessive bleeding leading to hospitalization after bone marrow biopsy and required blood transfusion. He was diagnosed with Waldenstrom's Macroglobulinemia (WM), based on the presence of IgM- κ type monoclonal (M) protein and infiltration of lymphoplasmacytic cells identified in bone marrow aspirates. He was noticed to have features of peripheral neuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS syndrome). This is a very rare case of WM with POEMS syndrome which responded to chemotherapy using bortezomib, steroids, and rituximab.