Nonsecretory Multiple Myeloma in a Seropositive Hepatitis B Patient with Thrombocytosis: A Case Report

Non-secretory Multiple Myeloma is a rare variant of multiple myeloma with similar clinical and radiological findings. It is characterized by the absence/lack of monoclonal M proteins in the serum and/or urine. An early diagnosis can help in alleviating its adverse outcomes. We report a case of a 56-year-old female presenting with generalized body weakness and swelling, pain in right lower chest and anorexia. The patient was a known case of hepatitis B, treated a month ago. There was an incidental finding of thrombocytosis. Serum biochemistry and protein electrophoresis showed no findings in favor of Multiple Myeloma. Bence Jones proteins were negative in the urine. X-ray revealed few lytic lesions on calvaria of the skull. Bone marrow biopsy helped in diagnosing the patient as a case of non-secretory type of multiple myeloma highlighting the important role of this modality in saving the life of a patient through early diagnosis.