Rapid Onset of B12 Deficiency in the Setting of Worsening Multiple Myeloma: Correlations between B12 Deficiency and Multiple Myeloma

A 67-year-old female with a relapse of multiple myeloma after being in remission for approximately 2 years following autologous stem cell transplant presented with worsening pancytopenia, over a three-month period. There were an increase in her monoclonal spike at 3.13 g/dL on serum protein electrop...

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Main Authors: Karan Seegobin, Satish Maharaj, Grant Nelson, Jeremy Carlson, Cherisse Baldeo, Rafik Jacob
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Case Reports in Oncological Medicine
Online Access:http://dx.doi.org/10.1155/2017/6458676
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author Karan Seegobin
Satish Maharaj
Grant Nelson
Jeremy Carlson
Cherisse Baldeo
Rafik Jacob
author_facet Karan Seegobin
Satish Maharaj
Grant Nelson
Jeremy Carlson
Cherisse Baldeo
Rafik Jacob
author_sort Karan Seegobin
collection DOAJ
description A 67-year-old female with a relapse of multiple myeloma after being in remission for approximately 2 years following autologous stem cell transplant presented with worsening pancytopenia, over a three-month period. There were an increase in her monoclonal spike at 3.13 g/dL on serum protein electrophoresis, low serum B12 levels, and positive intrinsic factor antibodies. Three months before, she had normal B12 levels and a significantly lower monoclonal spike of 1.07 g/dL. She was diagnosed with B12 deficiency with pernicious anaemia in the setting of her worsening myeloma. Multiple myeloma (MM) has been linked with B12 deficiency and pernicious anaemia. Several mechanisms have been described regarding the pathogenesis of B12 deficiency in such patients. Increased tumour activity can further perpetuate the development of B12 deficiency in such patients. With regard to our case, the increase in tumour activity and onset of pernicious anaemia could have contributed to the rapid development of B12 deficiency. In contrast to this, rapid development of B12 deficiency could also signify relapse or worsening of the myeloma as seen in our case. Physicians ought to consider B12 deficiency in patients with worsening pancytopenia and myeloma.
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spelling doaj-art-bf731ac0fbca42479ff26a68b873e00d2025-08-20T02:18:58ZengWileyCase Reports in Oncological Medicine2090-67062090-67142017-01-01201710.1155/2017/64586766458676Rapid Onset of B12 Deficiency in the Setting of Worsening Multiple Myeloma: Correlations between B12 Deficiency and Multiple MyelomaKaran Seegobin0Satish Maharaj1Grant Nelson2Jeremy Carlson3Cherisse Baldeo4Rafik Jacob5Department of Internal Medicine, University of Florida College of Medicine, Jacksonville, FL 32209, USADepartment of Internal Medicine, University of Florida College of Medicine, Jacksonville, FL 32209, USADepartment of Internal Medicine, University of Florida College of Medicine, Jacksonville, FL 32209, USADepartment of Internal Medicine, University of Florida College of Medicine, Jacksonville, FL 32209, USADepartment of Internal Medicine, University of Florida College of Medicine, Jacksonville, FL 32209, USADepartment of Internal Medicine, University of Florida College of Medicine, Jacksonville, FL 32209, USAA 67-year-old female with a relapse of multiple myeloma after being in remission for approximately 2 years following autologous stem cell transplant presented with worsening pancytopenia, over a three-month period. There were an increase in her monoclonal spike at 3.13 g/dL on serum protein electrophoresis, low serum B12 levels, and positive intrinsic factor antibodies. Three months before, she had normal B12 levels and a significantly lower monoclonal spike of 1.07 g/dL. She was diagnosed with B12 deficiency with pernicious anaemia in the setting of her worsening myeloma. Multiple myeloma (MM) has been linked with B12 deficiency and pernicious anaemia. Several mechanisms have been described regarding the pathogenesis of B12 deficiency in such patients. Increased tumour activity can further perpetuate the development of B12 deficiency in such patients. With regard to our case, the increase in tumour activity and onset of pernicious anaemia could have contributed to the rapid development of B12 deficiency. In contrast to this, rapid development of B12 deficiency could also signify relapse or worsening of the myeloma as seen in our case. Physicians ought to consider B12 deficiency in patients with worsening pancytopenia and myeloma.http://dx.doi.org/10.1155/2017/6458676
spellingShingle Karan Seegobin
Satish Maharaj
Grant Nelson
Jeremy Carlson
Cherisse Baldeo
Rafik Jacob
Rapid Onset of B12 Deficiency in the Setting of Worsening Multiple Myeloma: Correlations between B12 Deficiency and Multiple Myeloma
Case Reports in Oncological Medicine
title Rapid Onset of B12 Deficiency in the Setting of Worsening Multiple Myeloma: Correlations between B12 Deficiency and Multiple Myeloma
title_full Rapid Onset of B12 Deficiency in the Setting of Worsening Multiple Myeloma: Correlations between B12 Deficiency and Multiple Myeloma
title_fullStr Rapid Onset of B12 Deficiency in the Setting of Worsening Multiple Myeloma: Correlations between B12 Deficiency and Multiple Myeloma
title_full_unstemmed Rapid Onset of B12 Deficiency in the Setting of Worsening Multiple Myeloma: Correlations between B12 Deficiency and Multiple Myeloma
title_short Rapid Onset of B12 Deficiency in the Setting of Worsening Multiple Myeloma: Correlations between B12 Deficiency and Multiple Myeloma
title_sort rapid onset of b12 deficiency in the setting of worsening multiple myeloma correlations between b12 deficiency and multiple myeloma
url http://dx.doi.org/10.1155/2017/6458676
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