Amyloid arthropathy resembling seronegative rheumatoid arthritis in a patient with IgD-kappa multiple myeloma.
A 67-year-old woman suffered from symmetrical polyarthralgia and multiple joint swelling simulating rheumatoid arthritis (RA). Laboratory examination showed negative results for rheumatoid factor, decreased levels of IgG, IgA, and IgM, and an increased level of IgD. Immunoelectrophoresis in her serum and urine revealed an IgD-kappa monoclonal component and Bence Jones protein (kappa), respectively. A bone marrow biopsy showed an excess of atypical plasma cells. A synovial biopsy revealed amyloid deposition composed of IgD-kappa. She was diagnosed with amyloid arthropathy (AmyA) secondary to IgD-kappa multiple myeloma. It is important to pay attention to AmyA due to multiple myeloma in patients with seronegative RA.
Fujishima
Masumi
M
Third Department of Internal Medicine, Akita University School of Medicine, 1-1-1 Hondo, Akita 010-8543.
Komatsuda
Atsushi
A
Imai
Hirokazu
H
Wakui
Hideki
H
Watanabe
Wataru
W
Sawada
Ken-ichi
K
D000368:Aged; D000686:Amyloidosis / Q000175:diagnosis* / Q000209:etiology*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000276:immunology; D001536:Bence Jones Protein / Q000652:urine; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007072:Immunoglobulin D / Q000097:blood / Q000652:urine; D007145:Immunoglobulin kappa-Chains / Q000097:blood / Q000652:urine; D007592:Joint Diseases / Q000175:diagnosis* / Q000209:etiology*; D009101:Multiple Myeloma / Q000150:complications* / Q000276:immunology; D012217:Rheumatoid Factor / Q000097:blood
D007072:Immunoglobulin D; D007145:Immunoglobulin kappa-Chains; D001536:Bence Jones Protein; D012217:Rheumatoid Factor