XML Persian Abstract Print


1- SRL Diagnostics, National Reference Lab, Gurugram, India , rashmi.datta@agilus.in
2- SRL Diagnostics, National Reference Lab, Gurugram, India
Abstract:   (174 Views)
Background: Non-secretory multiple myeloma is a sporadic type of multiple myeloma with the proliferation of monoclonal plasmocytes in the bone marrow that cannot secrete or synthesize immunoglobulins.
Its prevalence as a hematologic malignancy is low, and it is usually diagnosed by demonstration of monoclonal plasma cells ≥ 10% in the bone marrow with negative results on serum and urine electrophoresis and immunofixation studies.
Methods: We present a case report where the patient's serum and whole blood samples were received in the study laboratory to evaluate the complete hemogram and metabolic profile. The metabolic and hematological profiles were deranged, subsequent to which the patient's clinical history was obtained from the treating clinician. It was discovered that the patient had presented with long-term weakness and back ache and was advised routine investigations along with magnetic resonance imaging (MRI) of the spine, which revealed the presence of osteolytic lesions. Following this, a gammopathy panel was requested.
Results: Serum protein capillary electrophoresis and immunofixation electrophoresis revealed a normal pattern without any noticeable bands, distortions, or suspicious regions. However, the findings of the comprehensive gammopathy panel were suggestive of non-secretory multiple myeloma.
Conclusion: In the absence of a detailed and meticulous work-up, a case of non-secretory multiple myeloma can be easily misdiagnosed. Here, we discuss the case in detail, the diagnostic pitfalls associated with it, and the role of serum free light chain assays in its diagnosis.

 
Full-Text [PDF 399 kb]   (58 Downloads) |   |   Full-Text (HTML)  (17 Views)  
Article Type: Case report | Subject: Oncology

References
1. Blade J, Kyle RA. Nonsecretory myeloma, immunoglobulin D myeloma and plasma cell leukemia. Hematol Oncol Clin North Am. 1999;13:1259-72. [View at Publisher] [DOI] [PMID] [Google Scholar]
2. Drayson M, Tang LX, Drew R, Mead GP, Carr-Smith H, Bradwell AR. Serum free light-chain measurements for identifying and monitoring patients with nonsecretory multiple myeloma. Blood. 2001;97(9):2900-2. [View at Publisher] [DOI] [PMID] [Google Scholar]
3. Corso A., Mangiacavalli S. Non-secretory myeloma: ready for a new definition? Mediterr J Hematol Infect Dis. 2017;9(1):e2017053. [View at Publisher] [DOI] [PMID] [Google Scholar]
4. Khurana U, Joshi D, Santoshi JA, Sharma T, Kapoor N. Oligosecretory multiple myeloma: a case report. Blood Res. 2016;51(1):63-5. [View at Publisher] [DOI] [PMID] [Google Scholar]
5. Coriu D, Weaver K, Schell M, Eulitz M, Murphy CL, Weiss DT, et al. A molecular basis for nonsecretory myeloma. Blood. 2004;104(3):829-31. [View at Publisher] [DOI] [PMID] [Google Scholar]
6. Dupuis MM, Tuchman SA. Non-secretory multiple myeloma: from biology to clinical management. Onco Targets Ther. 2016;9:7583-90. [View at Publisher] [DOI] [PMID] [Google Scholar]
7. Shaw GR. Nonsecretory plasma cell myeloma-becoming even rarer with serum free light-chain assay: a brief review. Arch Pathol Lab Med. 2006;130:1212-5. [View at Publisher] [DOI] [PMID] [Google Scholar]
8. Kelley MA, Mestre A, Ayau MF, Arpit A, Ratesh K. A Case Report of Non-secretory Multiple Myeloma. Cureus. 2022;14(9):e29571. [View at Publisher] [DOI] [PMID] [Google Scholar]

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 CC BY-NC 4.0 | Journal of Clinical and Basic Research

Designed & Developed by : Yektaweb

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0).