Marrow for her age (60%) with maturing trilineage hematopoisisĪnd involvement (10%) with a plasma cell neoplasm – IgA-kappa Smear, clot section, and core biopsy revealed a hypercellular (0.00-0.00) and urine IFE revealed kappa BJP. urinary Bence Jones protein (BJP) was high at 32.6 Light chain corresponding to IgG heavy chain lane. IgA heavy chain lane but two bands in kappa and lambda Lanes with one band in kappa light chain corresponding to Kappa + lambda polyclonal immunoglobulinemia (Figure 1).įigure 1: IFE: one band each in IgA and IgG heavy chain Serum immunofixationĮlectrophoresis (IFE) revealed IgA kappa (monoclonal) and IgG The serum albumin, calciumĪnd GFR were normal. MCV and MCH, and a platelet count of 161 x 109/L. Revealed a WBC 4.4 x 109/L, hemoglobin 10.3g/dL with a normal Her chest was clear toĪuscultation and vital signs were normal. To be mildly anemic but not in acute distress. On physical examination the patient was noted Macular degeneration, and a minor stroke. Medical history was significant for arthritis, GERD, diverticulitis, The patient did not have any major complaints except for back painĪnd pain in her right hip which was replaced three times. The patient, an 86 years old white female was referred for theĮvaluation and management of anemia and protein abnormalities. Keywords: Multiple Myeloma Smoldering Multiple Myeloma Monoclonal Gammopathy Significance of the presence of polyclonal immunoglobulin in multiple myeloma is Only (monoclonal) and one IgG kappa+lambda (polyclonal). Immunofixation electrophoresis identified two protein components, one- IgA kappa Whose serum protein electrophoresis revealed two spikes in gammaglobulins and Of monoclonal and polyclonal protein in the same case is rare. With respect to heavy chain or light chain or both. Than one (usually two) types of monoclonal proteins can be seen and they may differ Protein, one heavy chain and one light chain. Typically have a single clone of plasma cells, secreting a unique type of monoclonal The majority of patients with multiple myeloma (monoclonal gammopathies)
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