Clinical mismatches leading to the misdiagnosis of multiple myeloma as diabetic nephropathy: A case report

Table 1 Timeline of clinical events and interventions in 2025

Date (2025)	Clinical events and interventions
May	Onset of progressive fatigue and symptoms of anemia
June	Visited hematology clinic; Hb: 66 g/L, Cr: 220 μmol/L. Initial bone marrow cytology showed 5% plasma cells
July 13	Admitted to the Department of Endocrinology for suspected DN
Mid of July	Discovery of the three clinical mismatches (anemia-renal, protein-albumin gap, and lack of hypertension/edema)
Late of July	Performed follow-up bone marrow biopsy and serum free light chain testing
August 10	Confirmed diagnosis of λ-type multiple myeloma (stage III, group B)
August 30	Transferred to hematology; initiated bortezomib and dexamethasone chemotherapy
September 18	Follow-up: Hb rose to 84 g/L, Cr decreased to 147.8 μmol/L. Discharged after remission

Hb: Hemoglobin; Cr: Serum creatinine; DN: Diabetic nephropathy.