IgD Lambda Multiple Myeloma in a Paraplegic Female without Renal Involvement: A Case Report

Background: IgD multiple myeloma is a rare and aggressive variant of multiple myeloma, accounting for less than 2% of cases. It typically presents in younger males and is often associated with renal dysfunction and extensive extraosseous involvement 1,2. Case Presentation: We report a case of a 68-year-old paraplegic female patient presenting with chronic diffuse bone pain, pyramidal syndrome, and general deterioration. Laboratory workup revealed hypogammaglobulinemia. Immunofixation identified an IgD Lambda monoclonal band in serum and a corresponding Lambda band in urine. Bone marrow aspirate demonstrated 39% dystrophic plasma cells. Notably, renal function was preserved at diagnosis. Conclusion: This case highlights an unusual presentation of IgD Lambda multiple myeloma in an elderly female patient without initial renal involvement. Although the clinical presentation was severe, the absence of renal dysfunction at onset makes this case atypical and underscores the heterogeneity of IgD myeloma.