A Patient of Multiple Myeloma with Absent M (BAND)!!

Multiple myeloma constitutes a malignant proliferation of plasma cells acquired from a single clone. The tumor and its products and response of host to it causes number of organ dysfunctions, symptoms of which includes bone pain or fracture, rend dysfunction, vulnerability to infection, neurological symptoms, anemia, hypercalcemia, and clotting abnormalities, and manifestations of hyper viscosity. The median age of diagnosis in Indian population is 54 years. Males more commonly affected than females. In India, incidence of MM is 1.2 to 1.8 per 100,000 in males. We present a rare presentation of multiple myeloma with elevated serum free light chain and normal serum protein electrophoresis in contrast to more common presentation of abnormal serum protein electrophoresis. Multiple myeloma should not be excluded only on the basis of the absence of monoclonal gammopathy on protein electrophoresis. So, all the sub types of multiple myeloma need to be thoroughly studied to reach an accurate diagnosis.