Disseminated Intravascular Coagulation and Plasma Cell Leukemia

To the Editor.—  Plasma cell leukemia is a relatively rare plasma cell malignant condition. Bleeding abnormalities may develop during the course of the disease, most often caused by thrombocytopenia, adsorption of coagulation factors onto the paraprotein, or both. We report a case of plasma cell leukemia associated with disseminated intravascular coagulation (DIC).

Report of a Case.—  An 83-year-old woman was admitted to the hospital because of severe lower-back pain after a fall. She had no other complaints and was in good health before this hospitalization. The physical examination disclosed a temperature of 37.2 °C (99.1 °F), BP of 170/80 mm Hg, pulse rate of 72 beats per minute, and respirations of 18/min. She had no bruises, petechiae, rashes, lymphadenopathy, or hepatosplenomegaly; lungs were clear. A grade 2/6 systolic ejection murmur was heard at the left sternal border. The peripheral blood smear showed the presence of schistocytes and immature plasma cells.