Coexistence of Polycythaemia Vera with Indolent Myeloma in the same Patient.

We describe a patient with polycythaemia vera, who in the course of investigations for polycythaemia was also found to have multiple myeloma. A 75 year old Caucasian male was refered for investigations of a raised haemoglobin from a dermatology clinic. He was attending dermatology clinic for intractable, generalised pruritus for 6 months. Initial investigations confirmed the diagnosis of primary proliferative polycythaemia. Further examination of the bone marrow and trephine bone biopsy revealed an increase in plasma cells with morphological atypia. Serum protein electrophoresis confirmed a monoclonal band and urinary examination revealed excretion of Bence Jones proteins. Immunoperoxidase stains of the trephine biopsy confirmed monoclonal light chain restriction. Coexistence of polycythaemia vera and multiple myeloma is an extremely rare situation.