1981 Volume 22 Issue 10 Pages 1552-1557
A Case with Two M-components (IgG-κ, IgG-κ) was reported.
A 47 year-old female was admitted to our hospital for the further evaluation and treatment of liver dysfunction and low back pain on July 1979. Physical examination revealed mild anemia and tenderness of the lumber spine. Liver was not palpable. Laboratory findings were as follows. Erythrocyte sedimentation rate was normal 12mm/hr and Bence Jones protein in the urine was negative. Hematological examination showed mild anemia with a hematocrit value of 33.4%. Liver function test showed a ZTT of 12.6 units and TTT of 1.3 units. Serum electrophoresis showed an M-component of 15.5% and two M-components (IgG-κ, IgA-κ) were detected by immunoelectrophoretic studies. Serum IgG was measured to be 1700mg/dl, IgA 456mg/dl and IgM 47mg/dl by radial immunodiffusion method. Bone marrow examination showed 90000 nucleated cells/cmm with 9.4% plasma cell and the patient was considered to be in a premyelomatous stage with two M-components.
Cytometric study was performed on plasma cells in the bone marrow smear and histogram of the nucleus-cytoplasma ratio (N/C ratio) showed double peaks in their distribution. Discussion was made on the reference to the clonality of two M-components based on the morphological studies.
