7th September 2020

A 72-year-old gentleman presents to the GP with a history of gradual onset lumbar spine pain

A 72-year-old gentleman presents to the GP with a history of gradual onset lumbar spine pain. He has also become increasingly dyspnoeic, has had 5kg of unexplained weight loss in the last three months and feels generally lethargic. On examination, he has 1cm hepatomegaly. Bence-Jones proteins are seen in the provided urine sample, and the patient is referred to haematology for suspected multiple myeloma.

Which of the following clinical features is not a myeloma-defining event?

Select the SINGLE most appropriate option from the list below. Select ONE option only.