Diagnosis of an Immunoglobulin D multiple myeloma with severe renal involvement a decade after a solitary plasmacytoma: A case report and literature review
DOI:
https://doi.org/10.62438/tunismed.v103i1.5253Keywords:
bone, dialysis, neoplasm, plasma cell, uremiaAbstract
Introduction: Immunoglobulin D (IgD) myeloma is a rare subtype often described as aggressive with advanced disease at diagnosis. Primary renal involvement is seen in scarce cases.
Observation: This case features a 55-year-old man with IgD lambda myeloma presenting severe renal failure at diagnosis. Examination revealed a 10-year-old sternal plasmacytoma and multiple others in the ribs. Despite benefiting from traditional chemotherapy, he remained dependent on hemodialysis
Conclusion: Through this case, unique in the literature, we conclude that plasma cells secreting IgD can remain inactive for a long time in the form of a solitary plasmacytoma. However, in the event of medullary involvement, they can induce a myeloma with serious organic lesions.
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References
MacDougall KN, Rafay Khan Niazi M, Rehan M, Xue W, Dhar M. Immunoglobulin D Multiple Myeloma: A Rare Variant. Cureus. 2022;14(2): e21912.
Kumar P, Borz-Baba C, Raissi S. "D" is for dilemma. Cureus. 2019;11(9): e5669.
Bladé J, Lust JA, Kyle RA: Immunoglobulin D multiple myeloma: presenting features, response to therapy, and survival in a series of 53 cases. J Clin Oncol. 1994; 2398-2404.
Korbet SM, Schwartz MM. Multiple myeloma. J Am Soc Nephrol. 2006;17(9):2533-45.
Pham A, Mahindra A. Solitary plasmacytoma: a review of diagnosis and management. Curr Hematol Malig Rep. 2019;14(2):63-69.
Rajkumar SV. Updated diagnostic criteria and staging system for multiple myeloma. Am Soc Clin Oncol Educ Book. 2016;35: e418-23.
Fend F, Dogan A, Cook JR. Plasma cell neoplasms and related entities-evolution in diagnosis and classification. Virchows Arch. 2023;482(1):163-177.
Kyle RA, Gertz MA, Witzig TE, Lust JA, Lacy MQ, Dispenzieri A. Review of 1027 patients with newly diagnosed multiple myeloma. Mayo Clin Proc. 2003;78(1):21-33.
Rajkumar SV. Multiple myeloma: 2022 update on diagnosis, risk stratification, and management. Am J Hematol. 2022;97(8):1086-1107.
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;11(2): e4011.
Chen Y, Qiu Y, Fu H, Li J, Chen L, Liao et al. IgD multiple myeloma with central nervous system involvement: A case report and literature review. Mol Clin Oncol. 2021;15(4):198.
Li Y, Cai Z. Clinical characteristics and survival of patients with IgD multiple myeloma. Blood Sci. 2021;3(2):57-58.
Yan G, Li H, Zhang Y, Xia C, Wang M, Jia Y et al. Renal insufficiency predicts worse prognosis in newly diagnosed IgD multiple myeloma patients. Front Oncol. 2022; 12:1012889.
Toly-Ndour C, Peltier J, Piedagnel R, Coppo P, Sachon E, Ronco P et al. Acute renal failure with lambda light chain-derived crystals in a patient with IgD myeloma. Nephrol Dial Transplant. 2011;26(9):3057-9.
Sharma A, Binazir T, Sintow A, Lee CC, Shaharyar S, Tache J. An Extremely Rare Manifestation of Multiple Myeloma: An immunoglobulin D secreting testicular plasmacytoma. Cureus. 2017;9(6): e1400.
Warsame R, Gertz MA, Lacy MQ, Kyle RA, Buadi F, Dingli D et al.. Trends and outcomes of modern staging of solitary plasmacytoma of bone. Am J Hematol. 2012 ;87(7):647-51.
Hill QA, Rawstron AC, de Tute RM, Owen RG. Outcome prediction in plasmacytoma of bone: a risk model utilizing bone marrow flow cytometry and light-chain analysis. Blood. 2014;124(8):1296-9.
Knobel D, Zouhair A, Tsang RW, Poortmans P, Belkacémi Y, Bolla M et al. Rare Cancer Network. Prognostic factors in solitary plasmacytoma of the bone: a multicenter Rare Cancer Network study. BMC Cancer. 2006; 6:118.
Matĕja F, Tichý M, Zvarová M, Bucek J. IgD plasmacytoma--observations in 5 patients. Vnitr Lek. 1997;43(5):312-6.
Lu J, Lu J, Chen W, Huo Y, Huang X, Hou J; Chinese Medical Doctor Association Hematology Branch. Clinical features and treatment outcome in newly diagnosed chinese patients with multiple myeloma: results of a multicenter analysis. Blood Cancer J. 2014;4(8): e239.
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