Pleural and pericardial effusion as the first sign of multiple myeloma

We report a case of IgA-kappa multiple myeloma in a 68-year-old woman that was revealed by concomitant pleural and pericardial effusion. These effusio ns were found to be caused by myeloma and were verified by cytological exam ination of the pleural fluid and pericardial biopsy. The patient had neithe r osteolytic lesions nor Bence-Jones proteinuria. After a pericardiocentesi s, her condition improved with a melphalan and prednisolone treatment. As f ar as we know, such a phenomenon is rare and has never been reported yet as a way of diagnosing multiple myeloma.