Myeloma with biclonal IgG lambda and IgD kappa in serum : a case report
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1
Department of Immunology Habib Bourguiba university hospital, Tunisia
IgD myeloma is a rare entity (1-3%). Kappa subtype contributes only 10-30% of IgD myelomas and biclonal gammopathies involving IgD are even more rare.
In fact, biclonal bands constitute only 3-4% of all myelomas.
Case report : We report the case of a 57 years old women, who presented inflammatory low back pain and experienced a severe decline in general health. The symptoms were present 3 months before diagnosis. Laboratory test abnormalities included an elevated erythrocyte sedimentation rate (100mm /h), normochromic normocytic aplastic anemia, hypercalcemia (2,92 mmol/l), hyper-β2-microglobulin (2,87 mg/l). Serum protein electrophoresis showed hypergammaglobulinemia with a monoclonal peak in gamma region. Immunofixation detected an IgD Kappa band and a faint IgG lambda one. Bone marrow aspirated from the sternum was found to contain 30% of malignant plasma cells. Radiograph magnetic resonance imaging (MRI) disclosed myelomateous infiltration of dorsolumber spine and spondylolisthesis, with no evidence of spinal cord compression.
IgD myeloma is a particular severe form of myeloma often associated with poor prognosis. The pathogenesis is unclear. This case presents interesting findings regarding prognosis: We discuss, on one side, pronostic significance of biclonal gammopathy with IgD-Κappa comparing to the monoclonal IgD myelomas. On the other side, we analyze particularities of the IgD Kappa compared to the typical IgD lambda.
Keywords:
biclonal gammapathy,
IgD myeloma,
kappa subtype,
Myeloma Proteins,
pronostic
Conference:
15th International Congress of Immunology (ICI), Milan, Italy, 22 Aug - 27 Aug, 2013.
Presentation Type:
Abstract
Topic:
Immune-mediated disease pathogenesis
Citation:
Khlif
S
(2013). Myeloma with biclonal IgG lambda and IgD kappa in serum : a case report.
Front. Immunol.
Conference Abstract:
15th International Congress of Immunology (ICI).
doi: 10.3389/conf.fimmu.2013.02.01141
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Received:
19 Aug 2013;
Published Online:
22 Aug 2013.
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Correspondence:
Dr. Sana Khlif, Department of Immunology Habib Bourguiba university hospital, sfax, Tunisia, sanakhlif@yahoo.fr