Immunoglobulin D Multiple Myeloma, a More Aggressive Subtype

Eman EL-Sawalhy^1, , Najlaa Al-Sudani¹, Wehbi Hnayni¹ and Shahina Patel²

¹Department of Internal medicine, Beaumont Hospital, Dearborn, MI

²Division of Hematology & Oncology, Internal Medicine Department, Beaumont Hospital, Dearborn, MI

Cite this paper

Eman EL-Sawalhy, Najlaa Al-Sudani, Wehbi Hnayni and Shahina Patel. Immunoglobulin D Multiple Myeloma, a More Aggressive Subtype. American Journal of Medical Case Reports. 2021; 9(5):301-304. doi: 10.12691/AJMCR-9-5-11

Abstract

Immunoglobulin D (IgD) multiple Myeloma (MM) is a very rare subtype of myeloma. It accounts for only 1-2% of all MM patients. It is associated with a rapidly progressive disease and poorer outcomes compared with other MM subtypes. In this case report, we present a case of a sixty-year-old man who presented to our hospital with fatigue, anemia, thrombocytopenia, and acute renal failure. His bone marrow biopsy during admission showed 75.9% of plasma cells with significant light chain burden. He was also found to have severe immunoglobulin deficiency along with a lambda to kappa ratio was <0.01. The diagnosis of IgD MM was established, and he was started on CyBorD (Bortezomib, cyclophosphamide, and dexamethasone). Our patient also required hemodialysis for his kidney failure.

Keywords

Immunoglobulin D, multiple myeloma, renal failure, light chain nephropathy, CyBorD

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	M.K. Kim, C. Suh, D.H. Lee, C.-K. Min, S.J. Kim, K. Kim, J.H. Moon, S.S. Yoon, G.-W. Lee, H.J. Kang, S.-H. Kim, C.W. Choi, H.S. Eom, J.-Y. Kwak, H.J. Kim, Y.-C. Mun, S.-M. Bang, K. Lee, H.J. Shin, J.H. Lee, Immunoglobulin D multiple myeloma: response to therapy, survival, and prognostic factors in 75 patients, Annals of Oncology, 2011, Volume 22, Issue 2, Pages 411-416.
[2]	Djidjik R, Lounici Y, Chergeulaïne K, Berkouk Y, Mouhoub S, Chaib S, Belhani M, Ghaffor M. IgD multiple myeloma: Clinical, biological features and prognostic value of the serum free light chain assay. Pathol Biol (Paris). 2015 Sep; 63 (4-5): 210-4.
[3]	Modi J, Kamal J, Eter A, El-Sayegh S, El-Charabaty E. Immunoglobulin D Multiple Myeloma With Rapidly Progressing Renal Failure. J Clin Med Res. 2015 Aug; 7(8): 653-5.
[4]	Liu J, Hu X, Jia Y, Lu J, Lee JH, Kim K, Chen W, Liu A, Liu Y, Chen Q, Zhang C, Suh C, Kim MK, Zhou F, Chng WJ, Kumar SK, Durie B, Hou J, Fu W, Du J. Clinical features and survival outcomes in IgD myeloma: a study by Asia Myeloma Network (AMN). Leukemia. 2020 Oct 20.
[5]	Zhao Q, Li F, Song P, Zhou X, An Z, Mei J, Shao J, Li H, Wang X, Guo X, Zhai Y. Poor outcomes of immunoglobulin D multiple myeloma patients in the era of novel agents: a single-center experience. Cancer Commun (Lond). 2019 Sep 27; 39(1): 51.
[6]	Selene II, Jose JA, Khalil MJ, Faisal MS, Malik MN. Presentation Patterns, Diagnostic Markers, Management Strategies, and Outcomes of IgD Multiple Myeloma: A Systematic Review of Literature. Cureus. 2019 Feb 4; 11(2).
[7]	Farges C, Roussel M, Huynh A, Blancher A, Puissant-Lubrano B. Aggressive FLC Escape in a Patient with IgD Myeloma. Case Rep Hematol. 2015; 2015: 694730.
[8]	Pisani F, Petrucci MT, Giannarelli D, Bongarzoni V, Montanaro M, De Stefano V, La Verde G, Gentilini F, Levi A, Za T, Moscetti A, Annino L, Petti MC; Multiple Myeloma GIMEMA-Latium Region Working Group, Italy. IgD multiple myeloma a descriptive report of 17 cases: survival and response to therapy. J Exp Clin Cancer Res. 2012 Mar 1; 31(1): 17.