Immunoglobulin D lambda multiple myeloma and amyloidosis with predominant soft tissue involvement

Area of Science:

• Hematology
• Oncology
• Nephrology

Background:

• Multiple myeloma (MM) affects approximately 15% of patients with amyloidosis.
• Nephrotic syndrome, cardiomyopathy, and peripheral neuropathy are common manifestations.
• Amyloid arthropathy is an infrequent clinical feature of MM-associated amyloidosis.

Observation:

• This report details a patient with immunoglobulin D (IgD) lambda type MM.
• The patient presented with mucocutaneous amyloidosis and amyloid arthropathy.
• Notably, the patient showed no signs of nephrotic syndrome or cardiomyopathy.

Findings:

• The case illustrates a rare IgD myeloma with an unusual organ distribution of amyloid.
• Amyloid arthropathy and mucocutaneous involvement were the primary clinical features.
• Absence of cardiac or renal involvement deviates from typical MM-amyloidosis presentations.

Implications:

• This case expands the understanding of clinical heterogeneity in IgD myeloma.
• It underscores the importance of considering rare organ involvements in MM-associated amyloidosis.
• Highlights the diagnostic challenge posed by unusual presentations of rare myeloma subtypes.