title: [Systemic amyloidosis associated with IgD-λ multiple myeloma].
abstract: We describe here a case of systemic amyloidosis associated with IgD multiple myeloma. A 59-year-old man was admitted to our hospital in April 2009, because of macroglossia and swelling in both wrists and fingers. He had difficulty moving his limbs and was aware of peripheral neuropathy. Skin biopsy revealed extensive deposition of amyloidosis, which was positive by Congo red staining. Laboratory findings were as follows: serum electrophoresis revealed IgD λ monoclonal protein, and Bence-Jones protein was detected. Monoclonal IgD protein had a concentration of 727 mg/dl, and a bone marrow aspiration revealed 49.6% of plasma cells. These findings led to a diagnosis of IgD multiple myeloma with systemic amyloidosis. The patient was treated with MP (melphalan and methylprednisolone), high-dose dexamethasone and VAD therapy (vincristine, adriamycin and dexamethasone), but systemic amyloidosis progressed, and his general condition deteriorated. Coexistence of IgD multiple myeloma and systemic amyloidosis is rare, and accumulation of case reports is needed to gain a better understanding of this condition.
authors.affiliation: Department of Hematology, Kiyota Hospital.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Nagamachi
authors.forename: Naofumi
authors.initials: N
authors.lastname: Yamauchi
authors.forename: Hirohito
authors.initials: H
authors.lastname: Muramatsu
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Inomata
authors.forename: Eri
authors.initials: E
authors.lastname: Nozawa
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Koyama
authors.forename: Koji
authors.initials: K
authors.lastname: Ihara
authors.forename: Takuji
authors.initials: T
authors.lastname: Nishisato
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Yamada
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Yano
authors.forename: Shohei
authors.initials: S
authors.lastname: Kikuchi
authors.forename: Tasuku
authors.initials: T
authors.lastname: Hirako
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kitaoka
authors.forename: Kaoru
authors.initials: K
authors.lastname: Ono
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Ihara
authors.forename: Junji
authors.initials: J
authors.lastname: Kato
mesh_terms: D000686:Amyloidosis / Q000150:complications*; D006801:Humans; D007072:Immunoglobulin D / Q000097:blood*; D007146:Immunoglobulin lambda-Chains / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications*
chemical_list: D007072:Immunoglobulin D; D007146:Immunoglobulin lambda-Chains