The Story of a 63-year-old Woman

Anaemic syndrome

• Normocytic, normochromic anemia. Indiscriminate initiation of oral iron therapy!!
• 3 months later, back pain and metrorrhagia
• Progression on anaemia – normocytic, normochromic
• Gynaecological malignancy ruled out.
• Vitamin B12 i.m. added wrongly. Unnecessary referral for GIT endoscopy.
• After 6 months, pathological femoral neck fracture.
• Histology diagnosed myeloma.
• All that should have been done was timely protein electrophoresis and lumbosacral spine X-ray!!!
• The pathological fracture could have been avoided!!!
• Myeloma should always be considered! Do articulate your suspicion in time!