Autoimmune Hemolytic Anemia, Amoebic Dysentery, And Intracranial Hemorrhage as Rare Manifestations of Smoldering Multiple Myeloma: A Case Report

Background: Smoldering multiple myeloma (SMM) is in asymptomatic stages before overt multiple myeloma (MM) but it also has an increased risk of thrombosis, infection, autoimmune, and hemorrhage. SMM is usually recognized coincidentally during the workup of a variety of symptoms. Case Presentation: A 37-year-old male patient presented to the hospital with bloody diarrhea for two weeks. He was diagnosed with SMM with autoimmune hemolytic anemia (AIHA) and amoebic dysentery and treated for approximately 18 days then discharged to continue as an outpatient but he never attended. Seven months later he returned to the hospital with seizures. Computed tomography (CT-scan) was conducted, conforming had an intracranial hemorrhage and progressed to hydrocephalus. Conclusion: This case report shows that nowadays SMM needs to be aware even in the absence of progression to overt MM. Exploring medical history, physical examination, laboratory, and imaging examination need to be paid attention to carefully to diagnose SMM considering that it is often found coincidentally among various manifestations.