• CMAJ · Jun 2004

    Case Reports

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

    • Nicola Mumoli, Marco Cei, Roberto Incensati, and Serena Verzuri.
    • Department of Internal Medicine, Ospedale Civile, Livorno, Italy. nmumoli@tiscalinet.ca
    • CMAJ. 2004 Jun 8; 170 (12): 1809-10.

    AbstractThe differential diagnosis of fever of unknown origin includes infectious diseases, malignancies and connective tissue diseases. Multiple myeloma is not usually included in the differential diagnosis, 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, established with a marrow biopsy, was the presence of a paraprotein in the serum.

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