Myeloma IgD κ merupakan kasus keganasan sel plasma yang jarang dijumpai, dan belum pernah dilaporkan di Indonesia.Pada keadaan normal, kadar IgD dalam darah sangat rendah, sehingga peningkatan kadar IgD dalam darah dapat terlewatkan pada pemeriksaan elektroforesis protein serum. Pada makalah ini dilaporkan kasus seorang wanita 59 tahun dengan nyeri tulang hebat. Pemeriksaan radiologi menunjukkan adanya fraktur kompresi torakal dan penyempitan foramen torakal. Diagnosis mieloma pada pasien ini ditegakkan berdasarkan kriteria WHO, stadium berdasarkan kriteria Durie Salmon, dan prognosis buruk berdasarkan International Prognostic Index dari International Myeloma Working Group. Pada elektroforesis protein serum dijumpai spike monoklonal yang kecil dan pada imunofi ksasi didapatkan IgD κ and free light chain κ.
Abstract
IgD κ myeloma is a rare plasma cell neoplasm case and has never been reported before in Indonesia. In normal condition,IgD level in blood is very low, therefore increase of IgD level in myeloma could be missed by serum protein electrophoresis. A case of a 59 years old female with severe bone pain is reported. In radiology evaluation, there were thoracal compression fracture and thoracal foramen narrowing. For this patient, the myeloma diagnosis was based on WHO criteria, the stage IIIb was based on Durie and Salmon criteria, and bad prognosis with prognostic index stage III diagnosis was based on International Prognostic Index from International Myeloma Working Group, respectively. In serum protein electrophoresis we found a very small monoclonal spike and in immunofi xation there were monoclonal IgD κ and free light chain κ. |
