Waldenstrom macroglobulinemia presenting as isolated persistent epistaxis: a very rare presentation.

[waldenström macroglobulinemia]

Nose bleed is the most common rhinological emergency . There are multiple risk factors for the development of epistaxis and it can affect any age group , but it is the elderly population with their associated morbidity who often require more intensive treatment and subsequent admission . Most cases of epistaxis occur in the Little 's area , a location readily accessible and treatable by cautery or anterior nasal packing . However , posterior epistaxis often requires more aggressive measures including posterior nasal packing and endoscopic cauterization . After posterior nasal packing , the two most common therapies for intractable epistaxis are transantral ligation of the internal maxillary artery and percutaneous embolization of the distal internal maxillary artery . However , optimal management of intractable posterior epistaxis remains controversial . We hereby report fourth case of Waldenstrom Macroglobulinemia in English literature , which presented as isolated persistent epistaxis and was treated by therapeutic plasmapheresis .