Immunoglobulin D Multiple Myeloma Presenting as Spontaneous Fracture

Case Reports in Oncology
Samer Al HadidiGhassan Bachuwa

Abstract

Immunoglobulin D multiple myeloma is a rare type of multiple myeloma that usually presents as bone pain, fatigue, or weight loss. We report a case of immunoglobulin D multiple myeloma in a 53-year-old Caucasian male patient with previous medical history of anaplastic oligodendroglioma status post-surgical resection who was evaluated for back pain while mowing the lawn. His physical examination showed tenderness over the lower thoracic vertebrae with no sensory or motor impairment. Initial lab investigations showed normocytic anemia and hypercalcemia with low parathyroid hormone. Magnetic resonance imaging of thoracic spine with and without contrast showed acute pathological fracture of the T12 vertebral body with enhancing soft tissue which extended into the left ventral epidural space and left T11-T12 neural foramen. Serum protein electrophoresis showed abnormal protein band in the gamma globulin. Free light chain assay showed serum free kappa which was elevated at 3,090.0 mg/L (reference range 3.3-19.4 mg/L). Immunoglobulin D was elevated at 566.0 mg/dL (reference range <15.3 mg/dL). The patient was successfully treated with standard chemotherapy and autologous peripheral blood stem cell transplant with complete remission 3 y...Continue Reading

References

Nov 1, 1994·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·J BladéR A Kyle
Jan 8, 2000·Hematology/oncology Clinics of North America·J Bladé, R A Kyle
Jan 17, 2003·Mayo Clinic Proceedings·Robert A KylePhilip R Greipp
Aug 5, 2010·Annals of Oncology : Official Journal of the European Society for Medical Oncology·M K KimUNKNOWN Korean Multiple Myeloma Working Party
Mar 3, 2012·Journal of Experimental & Clinical Cancer Research : CR·Francesco PisaniUNKNOWN Multiple Myeloma GIMEMA-Latium Region Working Group, Italy
Jan 28, 2014·European Journal of Haematology·Flora ZagouriUNKNOWN Greek Myeloma Study Group

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Methods Mentioned

BETA
electrophoresis
biopsy

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