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April 1967

D-Myeloma: Report of Two Cases

Author Affiliations

Pittsburgh; Coral Gables and Miami, Fla

From the Medical Service, Veterans Administration Hospital, and the Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh (Dr. Zawadzki); and the Hematology Section, Veterans Administration Hospital, Coral Gables, and the Department of Medicine, University of Miami School of Medicine, Miami (Dr. Rubini).

Arch Intern Med. 1967;119(4):387-393. doi:10.1001/archinte.1967.00290220137011

IMMUNOGLOBULIN D1 has recently been added to the family of previously identified immunoglobulins, G, A, and M. (The terminology of this paper is based on the nomenclature proposed by the World Health Organization Committee.2) The detection of IgD in normal human serum followed the discovery of its pathological protein counterpart in the serum of a patient with clinical and pathological evidence of plasma cell myeloma, but with a unique myeloma protein.3 To date, the existence of only a few cases with this rare immunological type of paraprotein has been documented in the medical literature.3-6 Consequently, it appears worthwhile to record two additional cases of D-myeloma and to discuss the diagnostic difficulties involved in the electrophoretic and immunoelectrophoretic studies of this type of plasma cell myeloma.

Methods  Bence Jones protein in the urine was detected by the routine heating test of Snapper et al.7,8Standard paper electrophoresis on serum and urine

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