Alveolar haemorrhage as a presenting feature of myeloma.

An immunoglobulin A (IgA)-paraprotein secreting myeloma was found to be the underlying disease in a patient who presented with alveolar haemorrhage. The diffuse pulmonary bleeding stopped after initiation of treatment consisting of corticosteroids and melphalan. A paraprotein mediated lesion of the alveolar capillary membrane was suspected but could not be demonstrated.