Document Type : Case Report


Department of Adult Rheumatology, School of Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.


 Multiple myeloma can have different clinical manifestations, and not all patients present with a classic CRAB component. The acronym CRAB stands for the following traits of multiple myeloma: C = Calcium (elevated), R = Renal failure, A = Anemia, B = Bone lesions (bone pain). We describe a 53-year-old man who was referred to our hospital with a complaint of a rapidly progressive purpura/petechiae on the lower limb and abdomen, and multiple lytic lesions in the skull and spine, and multiple fractures. We documented an increased presence of plasmacytes in bone marrow aspiration and multiple lytic bone lesions, which led to a diagnosis of multiple myeloma. Although multiple myeloma presenting with purpura/petechiae is uncommon, it must always be considered as a differential diagnosis with this clinical finding. 


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