Immunochemical and ultrastructural study of multiple myeloma with a heavy chain protein in the serum.

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Abstract
A patient with multiple myeloma had antigenically related monoclonal Fc-.gamma. fragments and complete IgG-K molecules in the serum. The urine contained only Fc-.gamma. fragments in the absence of Bence-Jones protein. The 2 M-components in the serum showed electrophoretic identity but could be separated by chromatography. The simultaneous presence of complete monoclonal IgG molecules and Fc-.gamma. fragments, though difficult to detect, could be a frequent occurrence in multiple myeloma and it could be defined as double paraproteinemia. A detailed ultrastructural study was performed in this case and showed fibril bundles being released from the malignant plasma cells; such fibrils could be the supramolecular organization of the neosynthesised H chain fragments.