“D” is for Dilemma

Abstract

Immunoglobulin D (IgD) monoclonal gammopathy is a rare subtype of multiple myeloma (MM) associated with a worse prognosis compared with other variants of MM. A 61-year-old man with no known past medical history presented with complaints of abdominal pain, nausea, and vomiting for three weeks. Physical examination revealed mild epigastric tenderness. Laboratory data demonstrated a significantly elevated creatinine with minimal proteinuria and small abnormality in the gamma fraction. Ultrasound of the kidneys described normal-sized kidneys. Serum-free light chains and immunofixation were consistent with IgD kappa monoclonal gammopathy. Kidney biopsy revealed cast nephropathy. Bone marrow biopsy was remarkable for sheets of CD 38+ plasma cells comprising approximately 80% of the marrow cells. Recognizing the atypical presentation of IgD MM is crucial to facilitate early diagnosis and management and improve the prognosis of this subtype of MM.

Optimization of an Ultrasonic-Assisted Biodiesel Production Process from One Genotype of Rapeseed (TERI (OE) R-983) as a Novel Feedstock Using Response Surface Methodology

“…Research results of Hoekman et al [41] showed that in twelve types of biodiesel, the range of kinematic viscosity was from 4 to 5 mm 2 /s. According to Table 7, it is clear that the flash point, pour point, acid value, and oxidative stability are consistent with reports from other researchers [21,22,42]. It is important to note here that the properties of the produced biodiesel are in the range of the standard-defined properties (ASTM D6751 and EN 14112).…”

“…The results showed that using ultrasound irradiation reduces the reaction time, while the conversion percent and the quality of the biodiesel were the same as those of the conventional method. Kumar et al [21] investigated the effect of using ultrasound irradiation on decreasing the reaction time of biodiesel production from coconut oil. The results of their study indicated that using ultrasound irradiation reduces the reaction time by 15-40 min.…”

Diagnosis of Immunoglobulin D myeloma with severe renal involvement ten years after a solitary plasmacytoma

“…Immunoglobulin D multiple myeloma (IgD MM) is a rare isotype of multiple myeloma (MM), comprising less than 2% of all cases. It is often associated with an aggressive clinical course and a worse prognosis than other MM variants (1,2).…”