Biclonal Gammopathy

A 53 year old patient presented with backache. A skeletal survey was performed that showed punched out lesions in the skull. The bone marrow aspiration showed 21% plasma cells.  The haemoglobin was 10.1g/dL, serum calcium and creatinine were normal. Immunofixation electrophoresis showed a biclonal gammopathy both bands were IgA and λ. The free λ chain level was 179mg/L and the free κ chains level was 27.4 mg/mL with a free light chain ratio of 0.15.  The albumin was 2.5g/dL and the β-2 microglobulin 4.9mg/ml. The patients was diagnosed as multiple myeloma stage II by ISS and treated with bortezomib and dexamethasone followed by an autologous stem cell transplant.

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Biclonal Gammopathy

Source: All About Blood
Image credits: Avinash Deo

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