Abstract

To the Editor, Multiple myeloma (MM) develops due to clonal expansion of malign plasma cells. Abnormal plasma cells secrete abnormal immunoglobulins that can be detected monoclonally (M peak) in serum and/or urine via electrophoresis. MM manifests clinically and radiologically with anemia, hypercalcemia, renal failure, and lytic lesions in bones [1]. When the characteristic MM clinical and radiological findings are observed, but there is no monoclonal M peak based on electrophoresis, it is known as non-secretory multiple myeloma (NSMM)—a rare variant of MM [2,3]. NSMM is observed 1%-5% of all MM patients [4]. Hypercalcemia, which can present as mild to severe and life threatening, is the most common metabolic abnormality associated with MM, occurring in approximately 33% of patients [5]. Herein we report a patient diagnosed with NSMM after detecting hypercalcemia during follow-up 7 months after the start of hemodialysis treatment.

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