PMC8044764_01
(A) Chest computed tomography (CT) scan. (B) Protein electrophoresis for gamma globulin levels (black) before treatment. (C) Serum immunofixation electrophoresis demonstrating monoclonal IgG kappa proteins. (D) Bone marrow cytology (red arrows: plasma cells, x400). (E) Protein electrophoresis for gamma globulin levels (black) after autologous hematopoietic stem cell transplantation (ASCT).
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Chest computed tomography (CT) scan showed multiple compression fractures of the vertebral bodies (Figure 1A).The complete blood count showed normocytic anemia with a hemoglobin level of 101.0 g/L (130-175 g/L). Further serum protein electrophoresis revealed monoclonal spike 59.98 g/L (Figure 1B). Immunofixation electrophoresis (Figure 1C) showed immunoglobulin G 85g/L (8-15.5 g/L), immunoglobulin A 308 mg/L (836-2,900 mg/L), immunoglobulin M 250 mg/L (700-2,200 mg/L), kappa light chain 83.50 g/L and lambda light chain 0.84 g/L. Bone marrow cytology showed plasma cells made up 6.5% of the population (Figure 1D). His monoclonal spike was reduced by 75% and he showed clinical improvement (Figure 1E).