A comprehensive serological panel including myeloma screen, ANCA, anti-glomerular basement membrane (anti-GBM) antibodies, complement levels (C3, C4), and viral serologies showed high-titre myeloperoxidase (MPO)-ANCA positivity of 1280 CU (reference range: < 20 CU) while other test results were negative. Here, MPO is linked to plasma cell myeloma.