MULTIPLE-MYELOMA ARISING FROM MONOCLONAL GAMMOPATHY OF UNDETERMINED SIGNIFICANCE IN A PATIENT WITH GAUCHERS-DISEASE

We report the case of a 64-year-old woman who, 12 years after receivin g a diagnosis of Gaucher's disease with concurrent monoclonal gammopat hy of undetermined significance, developed worsening thrombocytopenia and bone pain. Bone marrow biopsy at this time revealed 50% plasma cel ls with a serum monoclonal immunoglobulin A-lambda level of 3.2 g/L. R oentgenography revealed a lytic clavicular lesion, and a diagnosis of multiple myeloma was made. To our knowledge, this case is the first to document the evolution of a monoclonal gammopathy of undetermined sig nificance to multiple myeloma in a patient with Gaucher's disease. The importance of investigating cytopenias and increased bone pain in suc h patients, perhaps by bone marrow biopsy, to rule out potentially mal ignant plasma cell dyscrasias is stressed.