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IgD-kappa myeloma: an unusual case
Amy M Tharp1, Ralph D Woodruff, Zak K Shihabi
127157, USA.
Insights
This study describes a rare biclonal immunoglobulin D-kappa and immunoglobulin G-kappa myeloma case. Early detection of IgD-kappa myeloma is crucial for effective treatment and patient outcomes.
Area of Science:
- Hematology
- Oncology
- Immunology
Background:
- Multiple myeloma is a plasma cell malignancy.
- Biclonal myeloma involves two distinct immunoglobulin types.
- IgD myeloma is rare and can be challenging to diagnose.
Observation:
- A patient presented with anemia, renal insufficiency, and proteinuria.
- An IgD-kappa myeloma component was initially overlooked.
- The IgD-kappa component showed a significant decrease post-treatment.
Findings:
- The biclonal myeloma involved both IgD-kappa and IgG-kappa.
- IgD-kappa levels decreased by approximately 90% after treatment.
- IgG-kappa levels decreased by approximately 40% over 9 years.
- The patient showed a good clinical response to treatment.
Implications:
- Highlights the importance of identifying rare myeloma subtypes.
- Suggests specific diagnostic strategies for biclonal myeloma.
- Emphasizes monitoring both immunoglobulin components in treatment.
Abstract:
A rare case of biclonal IgD-kappa and IgG-kappa myeloma is described. The patient initially presented with anemia, renal insufficiency, and proteinuria. The IgD-kappa, initially, was overlooked as a light chain; however, it decreased in serum concentration after treatment by approximately 90%, in contrast to the IgG-kappa that decreased in serum by approximately 40 % over a 9-yr period. Clinically, the patient responded well to treatment and improved greatly during this period. Practical recommendations are suggested in order to detect such cases.