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LETTER TO EDITOR Table of Contents   
Year : 2010  |  Volume : 44  |  Issue : 1  |  Page : 112
Nonsecretory multiple myeloma, how to make a diagnosis?

Wiwanitkit House, Bangkhae, Bangkok 10160, Thailand

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Date of Web Publication31-Dec-2009

How to cite this article:
Wiwanitkit V. Nonsecretory multiple myeloma, how to make a diagnosis?. Indian J Orthop 2010;44:112

How to cite this URL:
Wiwanitkit V. Nonsecretory multiple myeloma, how to make a diagnosis?. Indian J Orthop [serial online] 2010 [cited 2019 Dec 11];44:112. Available from:

I read the recent case report on nonsecretory multiple myeloma with a great interest. [1] Middela et al. noted that nonsecretory multiple myeloma is a case with diagnostic dilemma and "a high index of suspicion must be borne in mind when excluding multiple myeloma as a cause of pain, pathological fracture or lytic lesion". [1] Indeed, it is accepted that diagnosis of nonsecretory multiple myeloma is very difficult. In this case, although there are some soft signs showing myeloma nature (decreased normal immunoglobulin and lytic bone lesion), the lack of abnormal secreted protein brings the diagnostic difficulty. Recently, the new laboratory technique for detecting of low level of abnormal secreted protein has been developed and can be the new hope in the fast and easy diagnosis of nonsecretory multiple myeloma. The "Freelite™ test" is an example. This test helps determine low level of abnormal free light chain and has been accepted as the new tool for diagnosis of non secretory multiple myeloma. [2],[3]

   References Top

1.Middela S, Kanse P. Nonsecretory multiple myeloma. Indian J Orthop 2009;43:408-11.  Back to cited text no. 1  [PUBMED]  Medknow Journal  
2.Jung S, Kim M, Lim J, Kim Y, Han K, Min CK, et al. Serum free light chains for diagnosis and follow-up of multiple myeloma. Korean J Lab Med 2008;28:169-73.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]  
3.Pratt G. The evolving use of serum free light chain assays in haematology. Br J Haematol 2008;141:413-22.  Back to cited text no. 3  [PUBMED]  [FULLTEXT]  

Correspondence Address:
Viroj Wiwanitkit
Wiwanitkit House, Bangkhae, Bangkok 10160
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0019-5413.58615

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