Anderson Larry D, Bladé Joan, Kyle Robert A
Myeloma, Waldenstrom's, and Amyloidosis Program Hematologic Malignancies and Cellular Therapy Program Simmons Comprehensive Cancer Center UT Southwestern Medical Center Dallas Texas USA.
Department of Hematology Amyloidosis and Myeloma Unit Institut d'Investigacions Biomèdiques August Pi i Sunyer Hospital Clínic de Barcelona University de Barcelona Barcelona Spain.
EJHaem. 2024 Jan 10;5(1):235-237. doi: 10.1002/jha2.846. eCollection 2024 Feb.
The presence of a serum immunoglobulin D (IgD) monoclonal protein (M-protein) is seen in < 1% of patients with monoclonal gammopathies and is usually indicative of a malignant plasma cell disorder. Only a few cases of well-documented benign monoclonal gammopathy of undetermined significance (MGUS) of IgD subtype have been reported, and only 2 of those had over 5 years of follow-up at the time they were reported. Herein we describe longer-term follow-up of one of those 2 patients who has subsequently passed away from unrelated causes but never developed multiple myeloma or amyloidosis after 26 years of follow-up. Although IgD MGUS is extremely rare, this case confirms that presence of an IgD M-Protein is not always synonymous with a malignant plasma cell process.
血清免疫球蛋白D（IgD）单克隆蛋白（M蛋白）在不到1%的单克隆丙种球蛋白病患者中出现，通常提示恶性浆细胞疾病。仅有少数几例记录充分的IgD亚型意义未明的良性单克隆丙种球蛋白病（MGUS）报告，其中仅2例在报告时进行了超过5年的随访。在此，我们描述了这2例患者中1例的长期随访情况，该患者随后因无关原因去世，但在26年的随访中从未发展为多发性骨髓瘤或淀粉样变性。尽管IgD MGUS极为罕见，但该病例证实，IgD M蛋白的存在并不总是等同于恶性浆细胞过程。
