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CT scan showing a fracture of the left ilium (arrow), which caused a large hematoma.
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A computed tomography scan revealed a fracture of the left pelvic bone (Figure 1).
Clinical course of electrolyte disturbances (hypokalemia and hyper natremia/hyperchloremia) in association with treatment for multiple myeloma.. Notes: The numbers in the blue boxes running along the bottom of Figure 2 represent dates between November 12-16 and November 21-30, 2012, and December 1-3, 2012. The horizontal colored bars represent the normal ranges for sodium (green), chloride (pink), and potassium (pale blue).. Abbreviations: DEX, dexamethasone (8 mg per dose); ELN, elcatonin; KCl, potassium chloride; Na, sodium; NaHCO3, sodium bicarbonate; N/S, normal saline; TZ, 5% glucose; So11/3, soldem 1 and soldem 3 infusion fluids; Velcade, bortezomib (1.5 mg per dose).
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After the diagnosis of multiple myeloma with hypercalcemia, specific treatment was instigated, according to the following protocol (Figure 2): intravenous normal saline (Na, 154 mmol/L; Cl, 154 mmol/L; 500 mL x 2/day; daily), dexamethasone (8 mg per day x 2 consecutive days), NaHCO3 (80 mmol/L per day; daily), bortezomib (1.3 mg/m2 per dose, weekly), elcatonin (40 units per day for 5 consecutive days), and zoledronic acid hydrate (4 mg per dose, monthly).