{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T17:27:47Z","timestamp":1785259667080,"version":"3.55.0"},"reference-count":6,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,6,24]]},"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:p>Patients with multiple myeloma (MM) are at risk for acquired dysfibrinogenemia resulting in laboratory abnormalities and\/or bleeding complications. We describe a 63-year-old man who presented with bleeding diathesis in the presence of a low fibrinogen activity level with a normal fibrinogen antigen level. Further studies revealed elevated levels of lambda free light chains, and he was diagnosed with MM. Despite initiating treatment with bortezomib\/dexamethasone, he continued to have recurrent bleeds along with hypofibrinogenaemia, prompting a switch to carfilzomib\/dexamethasone. The patient responded with improvement in bleeding symptoms, normalisation of fibrinogen activity and a decrease in serum free light chains.<\/jats:p>","DOI":"10.1136\/bcr-2019-229312","type":"journal-article","created":{"date-parts":[[2019,7,18]],"date-time":"2019-07-18T06:55:11Z","timestamp":1563432911000},"page":"e229312","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Bleeding due to acquired dysfibrinogenemia as the initial presentation of multiple myeloma"],"prefix":"10.1136","volume":"12","author":[{"given":"Namrah","family":"Siddiq","sequence":"first","affiliation":[{"name":"Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"Bergstrom","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Larry D","family":"Anderson","sequence":"additional","affiliation":[{"name":"Division of Hematology Oncology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srikanth","family":"Nagalla","sequence":"additional","affiliation":[{"name":"Division of Hematology Oncology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,7,17]]},"reference":[{"key":"2025082708004652000_12.7.e229312.1","first-page":"357","article-title":"Results of tests used in the diagnostic evaluation of dysfibrinogenemia in multiple myeloma patients do not correlate with plasma fibrin clot properties","volume":"74","author":"Wojtowicz","year":"2017","journal-title":"Przeglad Lekarski"},{"key":"2025082708004652000_12.7.e229312.2","doi-asserted-by":"publisher","DOI":"10.1089\/152581601753193869"},{"key":"2025082708004652000_12.7.e229312.3","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.transci.2012.06.021","article-title":"A case of acquired dysfibrinogenemia in multiple myeloma treated with therapeutic plasma exchange","volume":"48","author":"Post","year":"2013","journal-title":"Transfus Apher Sci"},{"key":"2025082708004652000_12.7.e229312.4","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1159\/000160182","article-title":"Acquired dysfibrinogenemia secondary to multiple myeloma","volume":"120","author":"Kotl\u00edn","year":"2008","journal-title":"Acta Haematol"},{"key":"2025082708004652000_12.7.e229312.5","doi-asserted-by":"publisher","DOI":"10.1024\/0040-5930.56.9.491"},{"key":"2025082708004652000_12.7.e229312.6","article-title":"Acquired fibrinogen deficiency in multiple myeloma","volume":"195","author":"Macauley","year":"2017","journal-title":"Am J Respir Crit Care Med"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-229312","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:00:53Z","timestamp":1756306853000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-229312"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7]]},"references-count":6,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2019,7,17]]},"published-print":{"date-parts":[[2019,7]]}},"alternative-id":["10.1136\/bcr-2019-229312"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-229312","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,7]]}}}