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Nephrotic syndrome in a patient with IgM myeloma with associated neutrophilia
Author(s) -
Gnerre Paola,
Ottonello Luciano,
Montecucco Fabrizio,
Boero Michela,
Dallegri Franco
Publication year - 2007
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.1600-0609.2007.00869.x
Subject(s) - neutrophilia , plasma cell dyscrasia , medicine , multiple myeloma , nephrotic syndrome , leukocytosis , bence jones protein , proteinuria , plasma cell , pathology , gammopathy , plasma cell leukemia , immunology , monoclonal , antibody , immunoglobulin light chain , monoclonal antibody , kidney
An unusual case having IgM monoclonal gammopathy with clinical and pathologic features of multiple myeloma (MM) in association with neutrophilia and nephrotic syndrome is reported. The patient showed lytic bone lesions, decreased IgG and IgA levels, Bence‐Jones proteinuria, nephrotic proteinuria with edema, and histological plasma cell infiltration typical of MM. Moreover, mature neutrophilic leukocytosis, hepatomegaly, high leukocyte alkaline phosphatase score (LAP), absence of Philadelphia (Ph) chromosome and bcr gene rearrangement were also evidenced, all these features representing findings typical of the recently described plasma cell dyscrasia‐associated neutrophilia. After the diagnosis, the patient was treated with melphalan and prednisone, with an excellent response to the treatment. Different from the 30 cases so far reported, this is the first case of plasma‐cell dyscrasia with associated neutrophilia due to IgM‐producing monoclonal gammopathy. At the same time, this is the first reported case of nephrotic syndrome secondary to IgM myeloma.