Multiple myeloma is a plasma cell malignancy that classically presents with bone pain secondary to osteolytic lesions, anemia, and renal insufficiency. A 49-year-old man presented for workup of possible primary immunodeficiency due to a history of recurrent sinopulmonary infection and abnormal immunoglobulin levels. He was subsequently diagnosed with multiple myeloma, despite a lack of typical symptoms. The correct diagnosis of multiple myeloma can be easily overlooked, especially in a patient with recurrent infections but no other signs or symptoms typical of myeloma.
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