We present a patient with multiple myeloma and double (IgAk + IgGk) paraproteinaemia in the serum. Immunofluorescence analysis of bone marrow plasma cell with fluorochrome-conjugated goat antibodies specific for μ, δ, γ or α immunoglobulin heavy chain and k or λ light chains revealed the presence of a plasma cell clone synthesizing simultaneously γ, α and k chains. A minority of plasma cells synthesized γ or α chains separately. Moreover, in the patient’s peripheral blood, a few cells with the morphology of lymphoplasmoblasts and simultaneously positive for γ, α and k chains were also detected. These results indicate that in this patient, the neoplastic plasma cell clone was ‘frozen’ at the differentiative step of the switch from IgG to IgA synthesis.

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