Several factors have been implicated in the pathogenesis : Bone marrow (BM) infiltration by malignant plasma cells, hemodilution linked to the hyperprotidemia, Chemotherapy-induced bone marrow suppression, iron deficiency and vitamins, relative erythropoietin (EPO) deficiency (due partly to renal impairment) [6]. Here, EPO is linked to hyperinsulinemic hypoglycemia, familial, 4.