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

doi:10.4239/wjd.121606

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World Journal of Diabetes

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1948-9358

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Case Report

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Diabetes. Jun 15, 2026; 17(6): 121606
Published online Jun 15, 2026. doi: 10.4239/wjd.121606

Table 2 Comparative analysis of typical diabetic nephropathy vs. manifestations in this patient

Feature	Typical DN	Manifestations in this patient	Clinical significance
Anemia severity	Proportional to CKD stage (Hb approximately 90-100 g/L at eGFR 15-20 mL/minute/1.73 m²)	Severe anemia (Hb nadir 62 g/L)	Disproportionate anemia suggests bone marrow involvement
Proteinuria composition	Primarily albumin (high UACR)	Non-albumin protein (low UACR 52 mg/gvs high 24 hours-TP 1.07 g)	Indicates “overflow” light chains rather than glomerular leak
Blood pressure	Usually hypertensive due to volume overload	Normotensive (110/60 mmHg)	Points toward tubulointerstitial damage over glomerular damage
Edema	Common (systemic/peripheral)	Absent	Inconsistent with volume overload typical of advanced DN
Renal decline	Chronic and gradual progression	Rapidly progressive renal insufficiency	Red flag for NDRD

CKD: Chronic kidney disease; Hb: Hemoglobin; UACR: Urinary albumin-to-creatinine ratio; DN: Diabetic nephropathy; eGFR: Estimated glomerular filtration rate; TP: Total protein; NDRD: Non-diabetic renal disease.

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Citation: Li GZ, Liu JY, Hao HY, Zhou H. Clinical mismatches leading to the misdiagnosis of multiple myeloma as diabetic nephropathy: A case report. World J Diabetes 2026; 17(6): 121606
URL: https://www.wjgnet.com/1948-9358/full/v17/i6/121606.htm
DOI: https://dx.doi.org/10.4239/wjd.121606

Li GZ, Liu JY, Hao HY, Zhou H. Clinical mismatches leading to the misdiagnosis of multiple myeloma as diabetic nephropathy: A case report. World J Diabetes 2026; 17(6): 121606 [DOI: 10.4239/wjd.121606]

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