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

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.