Unusual Manifestations of Paraprotein-Associated Hematological Diseases: Report of 2 Cases and Literature Review

With this review we firstly describe uncommon manifestations of paraprotein-associated hematological diseases in 2 patients presenting with hemoptysis. The differential diagnosis in both cases included qualitative and quantitative platelet abnormalities, infectious diseases, malignancies, vasculitis, collagen diseases and blood disorders. Among other interventions undertaken, bone marrow biopsy provided evidence of a primary hematological disease while serum protein electrophoresis and immunofixation indicated the presence of a paraprotein. As a “take-away” lesson from the literature review performed on the basis of these cases the bleeding diathesis that is occasionally associated with paraproteinemia should be pointed out, irrespectively of the primary hematological condition. Thus, while investigating a patient with bleeding diathesis, at least a serum protein electrophoresis should be among the requested laboratory tests. Moreover, clinical vigilance is required in order to recognize other unusual manifestations of not so unusual hematological abnormalities.