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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">zdor</journal-id><journal-title-group><journal-title xml:lang="ru">Проблемы здоровья и экологии</journal-title><trans-title-group xml:lang="en"><trans-title>Health and Ecology Issues</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2220-0967</issn><issn pub-type="epub">2708-6011</issn><publisher><publisher-name>Gomel State Medical University</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.51523/2708-6011.2025-22-2-16</article-id><article-id custom-type="elpub" pub-id-type="custom">zdor-2837</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>СЛУЧАЙ ИЗ КЛИНИЧЕСКОЙ ПРАКТИКИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CLINICAL CASES</subject></subj-group></article-categories><title-group><article-title>Сложный случай диагностики множественной миеломы</article-title><trans-title-group xml:lang="en"><trans-title>Complex case of multiple myeloma diagnosis</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2250-8318</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Новикова</surname><given-names>И. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Novikova</surname><given-names>I. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новикова Ирина Александровна - д.м.н., профессор, заведующий кафедрой клинической лабораторной диагностики, аллергологии и иммунологии.</p><p>Гомель</p></bio><bio xml:lang="en"><p>Irina A. Novikova - Doctor of Madical Sciences, Professor, Head of the Department of Clinical Laboratory Diagnostics, Allergology and Immunology, Gomel State Medical University.</p><p>Gomel</p></bio><email xlink:type="simple">ir-nov@yandex.by</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4278-4328</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ходулева</surname><given-names>С. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Khoduleva</surname><given-names>S. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ходулева Светлана Александровна - к.м.н., доцент кафедры внутренних болезней № 1 с курсами эндокринологии и гематологии.</p><p>Гомель</p></bio><bio xml:lang="en"><p>Svetlana A. Khoduleva - Candidate of Medical Sciences, Associate Professor at the Department of Internal Diseases No. 1 with courses of Endocrinology and Hematology, Gomel State Medical University.</p><p>Gomel</p></bio><email xlink:type="simple">khoduleva@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0549-3150</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кадочкина</surname><given-names>Н. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Kadochkina</surname><given-names>N. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кадочкина Наталья Геннадьевна - к.м.н., врач-терапевт отделения аллергологии и иммунопатологии.</p><p>Гомель</p></bio><bio xml:lang="en"><p>Natalia G. Kadochkina - Candidate of Medical Sciences, Therapist at the Department of Allergology and Immunopathology, Republican Research Center for Radiation Medicine and Human Ecology.</p><p>Gomel</p></bio><email xlink:type="simple">natkadok@gmail.com</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3031-4214</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Романива</surname><given-names>О. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Ramaniva</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Романива Оксана Александровна - к.м.н. врач аллерголог-иммунолог отделения аллергологии и иммунопатологии.</p><p>Гомель</p></bio><bio xml:lang="en"><p>Aksana A. Ramaniva - Candidate of Medical Sciences, Allergologist and Immunologist at the Department of Allergology and Immunopathology, Republican Research Center for Radiation Medicine and Human Ecology.</p><p>Gomel</p></bio><email xlink:type="simple">romanivaok@yandex.by</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0441-684X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Макеева</surname><given-names>К. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Makeyeva</surname><given-names>K. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Макеева Ксения Сергеевна - старший преподаватель кафедры клинической лабораторной диагностики, аллергологии и иммунологии.</p><p>Гомель</p></bio><bio xml:lang="en"><p>Kseniya S. Makeyeva - Senior Lecturer at the Department of Clinical Laboratory Diagnostics, Allergology and Immunology, Gomel State Medical University.</p><p>Gomel</p></bio><email xlink:type="simple">mksens211@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Гомельский государственный медицинский университет</institution></aff><aff xml:lang="en"><institution>Gomel State Medical University</institution></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Республиканский научно-практический центр радиационной медицины и экологии человека</institution></aff><aff xml:lang="en"><institution>Republican Research Center for Radiation Medicine and Human Ecology</institution></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>29</day><month>06</month><year>2025</year></pub-date><volume>22</volume><issue>2</issue><fpage>133</fpage><lpage>139</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Новикова И.А., Ходулева С.А., Кадочкина Н.Г., Романива О.А., Макеева К.С., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Новикова И.А., Ходулева С.А., Кадочкина Н.Г., Романива О.А., Макеева К.С.</copyright-holder><copyright-holder xml:lang="en">Novikova I.A., Khoduleva S.A., Kadochkina N.G., Ramaniva A.A., Makeyeva K.S.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://journal.gsmu.by/jour/article/view/2837">https://journal.gsmu.by/jour/article/view/2837</self-uri><abstract><p>В статье представлен случай множественной миеломы (ММ) с минимальными изменениями лабораторных показателей, что препятствовало своевременному установлению диагноза. Приведены особенности клинических проявлений и сложности диагностики на этапах обследования пациентки.</p></abstract><trans-abstract xml:lang="en"><p>The article presents a case of multiple myeloma with minimal laboratory changes, which hindered timely diagnosis. The features of clinical manifestations and diagnostic challenges during the patient’s examination stages are described.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>множественная миелома</kwd><kwd>несекретирующая миелома</kwd><kwd>гипогаммаглобулинемия</kwd><kwd>протеинурия</kwd><kwd>суставной синдром</kwd></kwd-group><kwd-group xml:lang="en"><kwd>multiple myeloma</kwd><kwd>non-secretory myeloma</kwd><kwd>hypogammaglobulinemia</kwd><kwd>proteinuria</kwd><kwd>articular syndrome</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Бессмельцев С.С. 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