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NR, not reported.

aIn some series, data were not available in all cases.

bBlood urea nitrogen >75 mg/dL.

From Ref. 41, with permission from Elsevier.

NR, not reported.

aIn some series, data were not available in all cases.

bBlood urea nitrogen >75 mg/dL.

From Ref. 41, with permission from Elsevier.

with IgD myeloma have light-chain proteinuria, and more than half have more than 1 g/24 h.90 In most series of IgD myeloma, increased X light chain has been reported,87'88'9193 but in a large single-institution series the frequency of X light chain was 60%.90 IgD myeloma should always be excluded in patients with a discrete M-protein spike on serum protein electrophoresis and only a monoclonal k or X light chain on immunofixation.

In summary, patients with IgD myeloma often present with a small band or no spike on serum protein electrophoresis and light-chain proteinuria. Almost one-fifth have associated amyloidosis. Because these features are also typical of light-chain myeloma, IgD can be considered a variant. The presence of IgD M protein and the predominance of the X light chain are the major distinctive findings.

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