A Case of Non Secretory Type Multiple Myeloma Associated with Systemic Lupus Erythematosus

Yu-Jin Jeong; Hyun-Sook Kim; Eun-Jeong Kim; Yun Sung Kim; Chi-Young Park; Bong-Seok Shin; Geon Park

doi:10.4078/jkra.2010.17.4.431

Journal List > J Korean Rheum Assoc > v.17(4) > 1003766

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Jeong, Kim, Kim, Kim, Park, Shin, and Park: A Case of Non Secretory Type Multiple Myeloma Associated with Systemic Lupus Erythematosus

Original Article

J Korean Rheum Assoc 2010;17(4):431-436.

Published online: 23 December 2010

DOI: https://doi.org/10.4078/jkra.2010.17.4.431

A Case of Non Secretory Type Multiple Myeloma Associated with Systemic Lupus Erythematosus

Yu-Jin Jeong¹, Hyun-Sook Kim¹, Eun-Jeong Kim¹, Yun Sung Kim¹, Chi-Young Park¹, Bong-Seok Shin², Geon Park³

¹Departments of Internal Medicine, Chosun University College of Medicine, Gwangju, Korea

²Departments of Internal Dermatology, Chosun University College of Medicine, Gwangju, Korea

³Departments of Internal Laboratory Medicine, Chosun University College of Medicine, Gwangju, Korea

Received 16 August 201012 September 2010 Accepted 12 September 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The development of malignant tumors is a more frequent finding in lupus patients than the general population. However, the incidence of multiple myeloma associated with systemic lupus erythematosus (SLE) is a rare manifestation. SLE is an autoimmune disease characterized by B cell hyperactivity, formation of autoantibodies, and multi-clonal hypergammaglobulinemia. Serum immunoglobulin increases, with a specific increase in IgG, which is due to an increase in autoantibody formation related to extrinsic and intrinsic antigens. We report on a patient with SLE combined with IgG, lambda type nonsecretory multiple myeloma, which was diagnosed with refractory anemia and hypergammaglobulinemia.

Keywords: Nonsecretory multiple myeloma, Systemic lupus erythematosus

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Fig. 1.

Focal erythematous to brown colored papulopatches are evident on the forehead, with a butterfly- shaped malar rash across the cheeks except for the nasonabial fold.

Fig. 2.

Serum protein electrophoresis shows polyclonal gammopathy (A). Serum immunefixation electrophoresis shows no monoclonal gammopathy (B).

Fig. 3.

Bone marrow aspiration smear shows an increased number of abnormal plasma, cells with an eccentric nucleus composed of densely basophillic cytoplasm, and a perinuclear clear zone (A, ×400, hematoxylin and eosin [H/E]) (B, ×1,000, H/E). Bone marrow biopsy is dyed with Ig G stain (C, ×200) and lambda stain (D, ×1,000).

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