J Korean Rheum Assoc.  2010 Dec;17(4):431-436. 10.4078/jkra.2010.17.4.431.

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

• Jeong YJ
• Kim HS
• Kim EJ
• Kim YS
• Park CY
• Shin BS
• Park G

• KMID: 2201904
• DOI: http://doi.org/10.4078/jkra.2010.17.4.431

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.

Keyword

Nonsecretory multiple myeloma; Systemic lupus erythematosus

MeSH Terms

Anemia, Refractory
Autoantibodies
Autoimmune Diseases
Humans
Hypergammaglobulinemia
Immunoglobulin G
Immunoglobulins
Incidence
Lupus Erythematosus, Systemic
Multiple Myeloma
Autoantibodies
Immunoglobulin G
Immunoglobulins

Figure

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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.

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  Fig. 2. Serum protein electrophoresis shows polyclonal gammopathy (A). Serum immunefixation electrophoresis shows no monoclonal gammopathy (B).

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  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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