PMC7706130_01
Serum immobilized electrophoresis (IFE) revealed positive result for kappa-light chains.
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IgA, 0.10 g/L; IgM, 0.01 g/L) as well as elevated 24-hour urinary total protein (2.93 g/24 h) (Table 1). Immuno fixation electrophoresis (IFE) revealed a positive result for kappa-light chains (Figure 1).
The bone marrow image showed an MM bone marrow change (Wright stain).
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The bone marrow aspirate showed bone marrow changes typically seen in MM (Figure 2) and in combination with flow cytometry, plasma cells accounted for 58% of the total cell count.
Echocardiography showing increased ventricular mass and granular sparkling pattern of myocardium (black arrows).
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During hospitalization, echocardiography showed a further reduction in left ventricular systolic function and left ventricular diastolic function (Table 2) and granular sparkling pattern of the myocardium (Figure 3).
ECG showed ST-T abnormality after 3 months of admission.
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One month after admission, electrocardiography (ECG) showed ST-T abnormalities as opposed to the initial normal ECG (Figure 4).
Oral mucosal exfoliated cells showing multiple deposits of amyloid, positive for Red Congo stain (left) and with yellow birefringence under polarized light (right).
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Oral mucosal exfoliated cells showed positive staining for Congo Red stain (Figure 5).