ITP revealing a SMM: A case report and review of the literature

Immune thrombocytopenic purpura is an autoimmune disorder retained after elimination of other causes of low platelets' rate. It is mostly seen with B cell lymphoproliferative disorders. Immune thrombocytopenic purpura's association with plasma cell neoplasms is possible but extremely rare. Although several pathophysiological mechanisms have been proposed, the causal link between these two conditions is not yet clearly understood. Therapeutic management is not standardized and depends mainly on the type of gammopathy and the chronology of onset of immune thrombocytopenic purpura compared to multiple myeloma. Our case is about an 81-year-old male diagnosed with concurrent smoldering multiple myeloma and immune thrombocytopenic purpura who was started on steroids without anti-neoplastic therapy for multiple myeloma with partial platelet response. We also review the few reported cases of simultanious immune thrombocytopenic purpura and smoldering multiple myelom or multiple myeloma.