{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T21:15:21Z","timestamp":1778102121340,"version":"3.51.4"},"reference-count":0,"publisher":"Tunisian Society of Medical Sciences","issue":"02","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tunis Med"],"abstract":"<jats:p>Background: Multiple myeloma (MM) is a plasma cell malignancy with diverse clinical manifestations. Beyond the classic CRAB features(hypercalcemia, renal insufficiency, anemia, and lytic bone lesions), extramedullary involvement is rare and often life-threatening. This casehighlighted atypical and severe pulmonary\u2013pleural manifestations, emphasizing the diagnostic complexity of extramedullary disease.Case presentation: A 67-year-old hypertensive man was admitted with fever, dyspnea, and hemoptysis. He presented with pleural effusion,biologically confirmed alveolar hemorrhage, nephrotic-range proteinuria, and osteolytic lesions. Cytology demonstrated pleural plasmacyticinfiltration, and bone marrow aspiration showed 100% plasmacytosis. He was diagnosed with immunoglobulin G-kappa MM with pulmonary andpleural extramedullary disease and achieved partial remission with melphalan-dexamethasone, maintaining clinical improvement for 12 months.Conclusion: This case illustrated rare, severe extramedullary manifestations of MM with renal dysfunction as a key clinical clue. It underscored the importance of early recognition and comprehensive diagnostic evaluation. Prognosis remains poor in aggressive variants despite timely treatment.<\/jats:p>","DOI":"10.62438\/tunismed.v104i02.6519","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T20:54:12Z","timestamp":1778100852000},"source":"Crossref","is-referenced-by-count":0,"title":["Renal and Extramedullary Involvement Revealing Atypical Multiple Myeloma: A Case Report and a Literature Review"],"prefix":"10.62438","volume":"104","author":[{"given":"Zohra","family":"El Ati","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asma","family":"Hadhri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rihem","family":"Dahmane","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amel","family":"Ayed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mayssa","family":"Hadj brahim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raja","family":"Boukadida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karim","family":"Zouaghi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lazhar","family":"Jaballah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lamia","family":"Raies","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"31112","published-online":{"date-parts":[[2026,4,1]]},"container-title":["La Tunisie M\u00e9dicale"],"original-title":[],"deposited":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T20:54:13Z","timestamp":1778100853000},"score":1,"resource":{"primary":{"URL":"https:\/\/latunisiemedicale.com\/index.php\/tunismed\/article\/view\/6519"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,1]]},"references-count":0,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2026,4,1]]}},"URL":"https:\/\/doi.org\/10.62438\/tunismed.v104i02.6519","relation":{},"ISSN":["2724-7031","0041-4131"],"issn-type":[{"value":"2724-7031","type":"electronic"},{"value":"0041-4131","type":"print"}],"subject":[],"published":{"date-parts":[[2026,4,1]]}}}