?-Type I Myeloma and Xanthomatosis

Abstract

In multiple myeloma the concentration of serum lipoproteins is usually decreased.^1,10 In a few patients, lipoproteins are markedly increased.^11-16 Franklin et al²⁷ have examined two patients with γ-type myeloma of type I specificity associated with hyperlipoidemia. In these, elevation of cholesterol and/ or lipoproteins due to the fortuitous occurrence of thyroid or renal diseases ²⁵ or diabetes mellitus must be considered. Recently, several cases of myeloma associated with xanthomatosis have been reported.^1,17-23 We have had under observation a man with xanthomatous myeloma, splenomegaly, absence of osteolytic lesions, and the presence of an "M"-protein in the γglobulin range on serum paper electrophoresis. Attempts to correlate the various immunological types of myeloma (γ-, γ₂-A, and γmicron-, or Bence Jones)^1,2 with clinical manifestations suggested the existence of a subtype of γ₂-A-myeloma associated with xanthomatosis.^1,3 Xanthomatous myeloma, however, is not specifically associated with abnormal β₂-A-globulin as demonstrated by the following patient.