Kidney failure as an unusual initial presentation of biclonal gammopathy (IgD multiple myeloma associated with light chain disease): A case report

Rabrenović, Violeta; Mijusković, Z; Marjanovic, Slobodan; Rabrenovic, Milorad; Jovanović, D; Antić, Svetlana; Ignjatović, Ljiljana; Petrovic, M.; Pilcevic, Dejan

doi:10.2298/vsp140210027r

Cited by 6 publications

(4 citation statements)

References 12 publications

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“…Renal failure and Bence-Jones proteinuria are significantly higher with IgD myeloma compared to other subtypes, with renal failure present in 20-40% of patients at the time of diagnosis. 11,21 Renal injury may be caused by light chain cast nephropathy, or due to direct toxicity by intracellular crystals. 22,23 A recent study on risk factors of renal damage and prognosis in IgD myeloma reported that 55.3% of patients with IgD myeloma had renal damage as a complication, and that β2 microglobulin was an independent risk factor for renal damage.…”

Section: Resultsmentioning

confidence: 99%

Immunoglobin D Multiple Myeloma: A Single Centre Experience

Narayanan,

Menon,

M.T.

et al. 2024

EMJ

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Background: Immunoglobulin D (IgD) myeloma is an uncommon subtype of multiple myeloma that accounts for 1-2% of all myeloma cases. IgD myeloma is often associated with a high incidence of renal insufficiency, hypercalcaemia, extraosseous disease, amyloidosis, and Bence-Jones proteinuria.Materials and Methods: The authors discuss the clinical presentation and treatment results of 12 cases of IgD myeloma, treated at a single centre.Results: The study included nine males and three females, with a median age of 48.5 years. All had lytic bone lesions, eight had anaemia, five had renal impairment, three had hypercalcaemia, three had features of amyloidosis, and one had polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes syndrome. On immunofixation electrophoresis, 10 patients had IgD λ subtype, and two had IgD κ. Urine Bence-Jones protein was positive for five patients. Eleven patients received bortezomib-based chemotherapy. Three patients achieved complete response, two had a very good partial response, two achieved partial response,three progressed, and one discontinued treatment. At 2 years, six patients were alive (50%). Median overall survival of the series was 21 months (range: 1-80 months).Conclusion: IgD myeloma is an uncommon subtype of myeloma associated with a high incidence of hypercalcaemia, renal insufficiency, extraosseous lesions, amyloidosis, and Bence-Jones proteinuria. IgD λ disease is more frequent, unlike other subtypes of IgD myeloma. Management is similar to other myeloma types, but with poorer outcomes.

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Section: Resultsmentioning

confidence: 99%

Immunoglobin D Multiple Myeloma: A Single Centre Experience

Narayanan,

Menon,

M.T.

et al. 2024

EMJ

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“…Changes in the kidney tubules are dominant, while glomerulus and interstitial are much less affected. Kidney damage is caused by immunobiological activity of malignant clones, but also by deposits of immunoglobulin light chains that lead to obstruction of renal tubules and development of tubulointerstitial nephritis ( 9 , 10 ). Our patient, like other cases with IgD MM described in literature, had severe kidney failure.…”

Section: Discussionmentioning

confidence: 99%

A case report of biclonal immunoglobulin D lambda/lambda multiple myeloma in patient with liver echinococcosis

Čolak,

Raguž,

Dunđerović

et al. 2024

Biochem. med. (Online)

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“…The risk of renal damage in IgD MM is increasing and the patients with renal impairment tend to be younger (10). According to the litterature, renal failure is present in 20% to 40% of patients at the time of diagnosis (7) while primary kidney involvement and severe renal insu ciency are seen in only 15% to 20% of cases (4,11,12). The mechanisms of renal injury can be either due to light chain cast nephropathy or through the direct toxicity caused by intracellular crystals (7,11).…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of Immunoglobulin D myeloma with severe renal involvement ten years after a solitary plasmacytoma

mrabet

Hmida

2023

Preprint

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Immunoglobulin D myeloma is a rare subtype often described as aggressive with advanced disease at diagnosis. Primary renal involvement is seen in scarce cases. The aim of the present study was to describe the case of a 55‑year‑old male patient with immunoglobulin D‑λ myeloma who presented with severe renal failure at diagnosis. On examination, he presented a 10- year-old sternal arch. Investigations concluded a sternal plasmacytoma associated with multiple others in the ribs. He benefited from traditional chemotherapy and remained hemodialysis-dependent. We concluded that IgD-secreting plasma cells could remain quiescent for a long time in the form of a solitary plasmacytoma. However, in case of bone marrow involvement, they may induce myeloma with serious organic damage.

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Kidney failure as an unusual initial presentation of biclonal gammopathy (IgD multiple myeloma associated with light chain disease): A case report

Abstract: The presented rare form of double myeloma disease with initial renal insufficiency underscores the importance of careful observation and teamwork that can alter the course of this serious disease.

Cited by 6 publications

References 12 publications

Immunoglobin D Multiple Myeloma: A Single Centre Experience

Immunoglobin D Multiple Myeloma: A Single Centre Experience

A case report of biclonal immunoglobulin D lambda/lambda multiple myeloma in patient with liver echinococcosis

Diagnosis of Immunoglobulin D myeloma with severe renal involvement ten years after a solitary plasmacytoma

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