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.

Keywords:
Immunoglobulin synthesis, switch, Multiple myeloma, Paraproteinaemia, double
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© 1986 S. Karger AG, Basel
1986
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