Multiple myeloma and COVID-19

BACKGROUND: The current COVID-19 pandemic modifies current immunosuppressive treatment guidelines against several nephrological diseases. CLINICAL CASE: A 69-year-old female patient. Her current condition began with a nonspecific clinical picture of asthenia, adynamia, abdominal pain, nausea, and emesis. Upon admission to the service, serum sodium of 111 was found and correction of hydro-electrolytic imbalance was performed. Serum creatinine of 4.41 was found with an estimated glomerular filtration rate of 9.6 mL/min/1.73m2, in addition to hemoglobin anemia of 6.3 mg/dL. A TNK catheter was inserted in the operating room. While in the peritoneal dialysis unit, patient regained kidney function with a filtration rate of 20 mL/min. Patient was then readmitted to the internal medicine floor, where anemia and persistent hypercalcemia stood out. After being evaluated by the Hematology service, final diagnosis was multiple myeloma. Shortly before starting treatment, patient started exhibiting fever, cough, and headache. Chest tomography provided data suggestive of COVID-19. CONCLUSIONS: The clinical manifestations of multiple myeloma and chronic kidney disease are very varied, so the diagnostic approach is very important to avoid wrong diagnoses.