A Case Report of Atypical Presentation of Multiple Myeloma on Serum Protein Electrophoresis

Multiple myeloma is a group of B-cell disorders resulting in the secretion of a specific and unique monoclonal immunoglobulin (M-protein). Protein electrophoresis is advised whenever multiple myeloma is suspected. The M-protein usually migrates in the gamma or beta region of the normal protein pattern; very rarely it may appear in the alpha 2 or even in alpha I region. We report a rare case of multiple myeloma with biclonalgammopathyin 50 year old women who presented with generalised weakness, swelling over chest and lower back pain. Atypical case presentation where the patient with multiple myeloma presented with two M-spike in beta-globulin region on protein electrophoresis with hypoglobulinemia. To reveal the nature of M bands or clonality, serum Immunofixation study was performed which revealed IgA with kappa and IgM with kappa light chains. Such pattern is very rare if we consider the various immunofixation patterns observed in different gammopathies.