Usefulness of the blood chemistry screening associated with DXA imaging in a case of secondary osteoporosis in a young adult

Multiple myeloma is rare in young patients and may be undiagnosed or characterized by a significant delay in diagnosis. We report the association of stage I myeloma (according to Durie-Salmon classification) and osteoporosis in a 37-year-old male patient complaining of worsening pain in the spine. Pain attacks resulted in increases in blood pressure with hypertensive episodes. The investigations (on the basis of an unclear radiological picture and the presence of hypertensive state) led to the diagnosis of low grade osteoporosis. Since the young subject was symptomatic at the diagnosis, we continued evaluations on the basis of imaging data (DXA) and laboratory tests, revealing the presence of multiple myeloma. Clinical, laboratory, and therapeutic implications of this clinical case are discussed.