A Case of IgE Myeloma

Abstract

The 6th case of IgE myeloma in Japan (15th case in the world) was reported in the present communication.
71 year-old female was admitted to Orthopedic clinic of Sakura National Hospital on November 12, 1979 due to right shoulder pain which appeared on June 1979.
Osteolytic and osteoporotic foci were found in the skull, right scapula and right ilium bone without any physical and neurological signs. Complete blood countings were as follows: RBC 248×10⁴/mm³, Hemoglobin 8.3 g/dl, WBC 3,100/mm³, platelet 15.4×10⁴/mm³. Blood smear showed red cell rouleaux formation without any abnormal lymphoid or plasmacytoid cells.
Total serum protein level was 7.6 g/dl. Monoclonal protein was observed at fast γ-region by cellulose-acetate electrophoresis. On immunoelectrophoresis, this monoclonal protein made specific M-bow against anti-IgE and anti-kappa antisera. By single radial immunodiffusion, amount of IgE was calculated as 1.5 g/dl. 53.6% of bone marrow cell was myeloma cells which were stained with anti-IgE and anti-kappa antisera by indirect immunofluorescent technique.
Electronmicroscopic observation of myeloma cells revealed that those cells had plasmacytoid characteristics. Bence Jones protein was negative during clinical course and no renal dysfunction was observed.
Those findings supported the diagnosis of IgE myeloma with kappa light chain.
She has been treated with melphalan, cyclophosphamide, vincristine, ACNU and prednisone.