Presentation of Case A 66-year-old woman was admitted to the hospital because of Waldenström's macroglobulinemia, with severe weakness, diarrhea, and gastrointestinal bleeding. There was a long history of abuse of tobacco and alcohol. The patient was otherwise in a stable state of health until two months before admission, when fatigue, myalgia, arthralgia, and a low-grade fever developed, with occasional night sweats. Diarrhea, weakness, and peripheral edema soon appeared, and she was admitted to another hospital. Physical examination showed splenomegaly without hepatomegaly; there was prominent peripheral edema. The hematocrit was 26 percent; the mean corpuscular volume (MCV) was 114 μm3 per.
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