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Hindi Gastrointestinal bleeding secondary to acquired factor x deficiency in the setting of multiple myeloma
*Corresponding Author:
Copyright: © 2020 . This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
A 59 year-old male with no prior history of coagulopathy presented to the hospital with recurrent gastrointestinal bleeding. Diagnostic studies revealed creatinine of 3.13 g/dL, hemoglobin of 6 g/dL, platelets of 106,000/microliter and INR of 3.3, with bleeding gastric and duodenal ulcers on endoscopy. Blending considers distinguished coagulation factor inadequacy, low direct factor X and factor X action<2%. Serum protein electrophoresis showed no monoclonal protein, but serum kappa/lambda free light chain ratio was elevated at 174.78. Bone marrow biopsy demonstrated 20-50% atypical plasma cells and absent high risk cytogenetics by FISH. Diagnosis turned into made as level III a couple of myeloma with acquired issue X deficiency. Treatment worried bortezomib, dexamethasone and component X infusions, accompanied by means of melphalan autologous stem cell transplant. By day 40 posttransplant, patient accomplished independence from issue X infusions. Bleeding happens in up to 15% of patients with a couple of myeloma, however is rarely the presenting symptom. Factor X deficiency, defined by using Factor X activity.
