Unconventional Presentation of Smoldering Multiple Myeloma: A Case Study

Presentation of Smoldering Multiple Myeloma

Abstract

Haematological malignancy multiple myeloma (MM) affects elderly people and causes abnormal plasma cell development in the bone marrow. Despite its low prevalence, MM causes severe illness and death. Patients often experience anaemia, bone discomfort, and renal failure. Acute kidney injury (AKI) and myeloma cast nephropathy result in significant renal complications that require quick identification and treatment. This 52-year-old woman originally resembled smoldering multiple myeloma (SMM) but later had acute renal failure due to myeloma cast nephropathy. Haemodialysis continued despite timely chemotherapy initiation since renal function did not improve. Hypercalcemia and lytic bone lesions were absent in our patient, making the diagnosis difficult. SMM has a much lower incidence than MM, according to the literature. Early identification and treatment are crucial for high-risk SMM patients who develop MM. Our report illustrates the diagnostic difficulty of atypical MM, especially when traditional indicators are normal or absent. A primary symptom of renal involvement can delay identification and therapy. This case shows that MM diagnosis and treatment require strong clinical suspicion and full assessment, including a kidney biopsy when necessary. Clinicians must report unexpected MM presentations and consider it a diagnosis in patients with significant symptoms.