A 50 years old depressed man, under my treatment from last twenty-five years, one-day he came with extreme weakness, changed the face, anemic Hb7.6 gm %, pain over the right lower chest. The liver was hypoechoic and congested, enlarged. Lymph nodes in porta hepatis are enlarged. I V iron 400mg given but didn't improve, lost appetite also, but never complained of bone pain or renal symptoms.
LFT marginally raised with ALK phosphatase markedly raised 354 IU. He was on Atenolol, Amlodipine, Equilibrium, B1B6B12. For many years. Is this a case of multiple myeloma?
