A case of IgD myeloma representing a missed biclonal paraproteinemia or isotype switch in a patient previously diagnosed with IgA-lambda myeloma

Julie Chepovetsky; Ajai Chari; Sundar Jagannath; Lakshmi Ramanthan

doi:10.1016/j.cca.2013.08.004

A case of IgD myeloma representing a missed biclonal paraproteinemia or isotype switch in a patient previously diagnosed with IgA-lambda myeloma

Clin Chim Acta. 2013 Oct 21:425:233-5. doi: 10.1016/j.cca.2013.08.004. Epub 2013 Aug 13.

Authors

Julie Chepovetsky¹, Ajai Chari, Sundar Jagannath, Lakshmi Ramanthan

Affiliation

¹ Mount Sinai Hospital, Dept of Pathology, Gustave L Levy Place, Box 1194, New York, NY 10128, USA. Electronic address: juliechepovetsky@gmail.com.

PMID: 23954772
DOI: 10.1016/j.cca.2013.08.004

Abstract

Background: Multiple myeloma is a clonal plasma cell neoplasm that is identified in the laboratory by a presence of a monoclonal immunoglobulin or increased plasma light chain levels.

Methods: The most commonly identified and tested immunoglobulins are IgA, IgG and IgM.

Results: Rare cases of multiple myeloma present with monoclonal IgD and IgE paraproteins.

Conclusion: We present a case of IgD myeloma diagnosed in a patient who had achieved partial remission from a previously diagnosed IgA myeloma, possibly representing a missed biclonal paraproteinemia or isotype switch after treatment.

Keywords: Biclonal myeloma; IgD; Immunofixation; Isotype switch; Multiple myeloma.

Publication types

Case Reports

MeSH terms

Adult
Clone Cells
Delayed Diagnosis
Humans
Immunoglobulin A / blood*
Immunoglobulin Class Switching
Immunoglobulin D / blood*
Immunoglobulin lambda-Chains / blood*
Male
Multiple Myeloma / blood
Multiple Myeloma / diagnosis*
Multiple Myeloma / immunology

Substances

Immunoglobulin A
Immunoglobulin D
Immunoglobulin lambda-Chains