The presence of two or more anomalous immunoglobulins is uncommon. Previously, only six patients have been described with coexisting Waldenström macroglobulinemia and IgG or IgA multiple myeloma. We have seen one additional patient. The clinical history and pathological findings of this patient did not follow the pattern seen in the other six patients, that is, although he had a much higher serum concentration of IgG than of IgM, his symptoms were those of Waldenström macroglobulinemia, not those of IgG myeloma. The immunochemical findings from this patient have suggested new insights into the genetic control of "normal" immunoglobulins. When added to the information on his prolonged clinical course, these findings may expand our knowledge of the pathogenesis of neoplasia in patients with paraproteinemia.
Since early childhood, our patient, born in 1909, had had episodes of yellow pallor associated with aching in the bones, headaches, delirium, chills, fever, anorexia, malaise,
McNutt DR, Fudenberg HH. IgG Myeloma and Waldenström Macroglobulinemia: Coexistence and Clinical Manifestations in One Patient. Arch Intern Med. 1973;131(5):731–734. doi:10.1001/archinte.1973.00320110115018
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