Light chain multiple myeloma: an evaluation of its biochemical investigations

• Main Authors: Zahari Sham, Siti Yazmin, Chellappah Thambiah, Subashini, Samsudin, Intan Nureslyna, Lim, Say Min
• Format: Article
• Language: English
• Published: Malaysian Society of Pathologists 2017
• Online Access: http://psasir.upm.edu.my/id/eprint/62306/1/Light%20chain%20multiple%20myeloma.pdf; http://psasir.upm.edu.my/id/eprint/62306/; http://www.mjpath.org.my/2017/v39n3/index.php

Multiple myeloma is a type of plasma cell dyscrasia, characterised by presence of paraprotein or monoclonal (M)-protein in serum or urine. The M-protein may consist of an intact immunoglobulin, the heavy chain only or the light chain only. The latter, designated as light chain multiple myeloma (LCMM) makes up almost 20% of myelomas. Clinical manifestation is often heralded by hypercalcaemia, renal impairment, normocytic normochromic anaemia and bone lesions, reflecting end-organ damage, collectively known as the acronym CRAB. In particular, free light chain nephrotoxicity accounts for the high prevalence of renal impairment seen in LCMM. This case illustrates a typical presentation of LCMM with focal discussion on its initial and diagnostic, as well as prognostic biochemical investigations.