FEET IN MULTIPLE WAYS - CASE STUDY.

The Multiple Myeloma is a cancer of plasma cells, representing 1% of all cancers and 13% of hematological malignancies. Fundamentally affects men with an average age of 68 years. The main causes of death is associated with an infectious disease, and renal and 97% of diagnoses show a peak in the monoclonal protein electrophoresis. Being 20-30% asymptomatic is essential that the GP, following his ill periodically have this diagnosis this before symptoms of recurrent bone pain, frequent infections and abnormal blood counts. Man 67, married and retired, submit to the GP complaints of cough and hemoptysis; before the hearing are asked to x-ray of the chest demonstrating deletion of costo-phrenic right breast. It is sent to the pulmonology Diagnostic Center urgently discarding the hypothesis of pulmonary tuberculosis. Analytically presents NN anemia 10,3g VS Hg and 133 mm / h. Start antibiotic treatment and after 4 days has pruritic, hemorrhagic and necrotic lesions in the lower limbs, which associates allergy nylon and / or antibiotic. In urgent consultation of Dermatology leukocytoclastic injuries are diagnosed, so the GP repeated blood count and protein electrophoresis urgent. Already in the hospital setting is diagnosed with multiple myeloma monoclonal IgG peak associated with hyper viscosity syndrome, leading to beginning chemotherapy. The Multiple Myeloma is a serious disease also diagnosed in primary care, where doctor-patient relationship is essential for the early diagnosis of infrequent pathologies.