Which of the following is the least common feature of Multiple Myeloma:

Answer is D (Hyperviscosity syndrome) Hyperviscosity syndrome is an uncommon /infrequent complication/presentation of Multiple myeloma. Hyperviscosity syndrome is an infrequent/uncommon complication/presentation of multiple myeloma The Monoclonal 'M' component in Multiple Myeloma usually consists of monoclonal IgG or monoclonal IgA. Hyperviscosity syndrome from monoclonal IgG/IgA in multiple myeloma is an infrequent/uncommon event, though when present it is potentially destructive. Hyperviscosity syndrome is commonly seen with monoclonal 1gM as in Waldenstrom's Macroglobulinemia `Although potentially destructive hyperviscosity is a relatively uncommon complication of multiple myeloma' In Multiple Myeloma, Hyperviscosity has been described in 3-4% of IgG Myeloma and 5-10% of IgA Myeloma. Review 'Patients with multiple myeloma develop hvperviscosity infrequently' - Oxford Desk Reference Bone pain (skeletal destruction), Anemia and Susceptibility to bacterial infections are frequent/common features of Multiple Myeloma Bone Pain `Bone Painis the most common symptoms in myeloma affecting nearly 70% of patients' - Harrison 18m/938 Susceptibility to Bacterial Infection `The most common clinical problem (after skeletal destruction) in patients with multiple myeloma is susceptibility to bacterial infections' `>75% of patients will have a serious infection at some time in their course and recurrent infections are the presenting feature in approximately 25% of patients. ' - Harrison 18th/938 Anemia Wormocytic Normochromic anemia is present in approximately 80% of myeloma patients' Clinical Feature of M. Myeloma Approximate frequency Bone pain/skeletal Destruction - 70% (Most common presenting feature) Recurrent bacterial Infection - > 25% (Presenting _feature in > 25%) Renal failure - > 25% (Renal Failure occurs in - 25% of MM patients) Hypercalcemia - 25% (About 25% of patients develop Hypercalcemia at some stage of disease. It is the most common cause of Renal failure in MM patient) Anemia (Normocytic Normochromic) ' 80% (Normocytic Normochromic anemia occurs in approx. 80% ofpatients. It is usually not a presenting feature.)