{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T13:03:52Z","timestamp":1781096632461,"version":"3.54.1"},"reference-count":20,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,2,10]]},"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p>Classical CRAB features (hypercalcaemia, renal failure, anaemia, osteolytic lesions) have been traditionally defined in patients with plasma cell dyscrasia. But these can be rare and uncommon presentations of other chronic lymphoproliferative disorders (CLPD). The pathophysiological basis of CRAB features in other CLPD need to be explored further for better outcomes and therapeutic interventions. These can present a diagnostic dilemma and requires extensive workup to rule out coexisting malignancy and myeloma. Here, we report an unusual case of B CLPD in a middle-aged male who presented with classical CRAB features along with a brief literature review. After detailed investigations, he was diagnosed as chronic lymphocytic leukaemia, without any second malignancy and responded well to ibrutinib-based therapy.<\/jats:p>","DOI":"10.1136\/bcr-2020-238864","type":"journal-article","created":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T10:56:18Z","timestamp":1614682578000},"page":"e238864","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Hypercalcaemia, renal failure, anaemia and osteolytic lesions (CRAB) in chronic lymphocytic leukaemia mimicking multiple myeloma"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9009-1302","authenticated-orcid":false,"given":"Tribikram","family":"Panda","sequence":"first","affiliation":[{"name":"Hematology, All India Institute of Medical Sciences, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9885-1625","authenticated-orcid":false,"given":"Mukul","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"Hematology, All India Institute of Medical Sciences, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saumyaranjan","family":"Mallick","sequence":"additional","affiliation":[{"name":"Pathology, All India Institute of Medical Sciences, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmita","family":"Dass","sequence":"additional","affiliation":[{"name":"Hematology, All India Institute of Medical Sciences, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,3,2]]},"reference":[{"key":"2025082623154144000_14.3.e238864.1","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.annonc.2020.09.019","article-title":"Chronic lymphocytic leukaemia: ESMO clinical practice guidelines for diagnosis, treatment and follow-up","volume":"32","author":"Eichhorst","year":"2021","journal-title":"Ann Oncol"},{"key":"2025082623154144000_14.3.e238864.2","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2018GS110801"},{"key":"2025082623154144000_14.3.e238864.3","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1200\/GO.20.00032","article-title":"Chronic lymphocytic leukemia: real-world data from India","volume":"6","author":"Tejaswi","year":"2020","journal-title":"JCO Glob Oncol"},{"key":"2025082623154144000_14.3.e238864.4","article-title":"Acute renal failure secondary to chronic lymphocytic leukemia: a case 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failure due to leukaemic infiltration in chronic lymphocytic leukaemia","volume":"2015","author":"Kayar","year":"2015","journal-title":"Case Rep Med"},{"key":"2025082623154144000_14.3.e238864.16","doi-asserted-by":"crossref","first-page":"65","DOI":"10.5045\/br.2017.52.1.65","article-title":"Hypercalcemia, multiple osteolytic lesions, and acute renal failure: a rare presentation of B-cell acute lymphoblastic leukemia","volume":"52","author":"Puri","year":"2017","journal-title":"Blood Res"},{"key":"2025082623154144000_14.3.e238864.17","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2018-229070","article-title":"Hypercalcaemia, renal dysfunction, anaemia and bone lesions (crab) do not always represent multiple myeloma: diffuse large B cell lymphoma presenting with crab symptoms in a 69-year-old man","volume":"12","author":"Abdullah","year":"2019","journal-title":"BMJ Case Rep"},{"key":"2025082623154144000_14.3.e238864.18","first-page":"185","article-title":"Chronic lymphocytic 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