Symptomatic Multiple Myeloma in the Second Trimester of Pregnancy: A Case Report
Hacene Meriche, Sara Zaghez, Feriel Sandra Bouafia, Boutheina Abdaoui, Nacima Sabiha Gadiri, Hichem Frigaa
Asian Journal of Immunology · pp. 222–229 · Published 15 Sep 2025
10.9734/aji/2025/v8i1173Abstract
Multiple myeloma (MM) in pregnant women is a rare disease characterized by clonal proliferation of plasma cells producing monoclonal immunoglobulin, which suppresses the normal production of other antibodies and weakens the maternal immune response. Plasma cells release inflammatory cytokines (IL-6, TNF-α, IL-1β) that promote their survival and bone destruction. During pregnancy, maternal immunity shifts towards complex tolerance with decreased Th1 inflammatory responses, Th2 predominance, and increased regulatory T cells, which often masks MM and complicates its management. Treatment is generally deferred until after delivery to protect the fetus, with the VTD protocol then used to control the disease by reducing plasma cell proliferation and inflammation. This case illustrates the importance of simple tests such as serum protein electrophoresis in diagnosing unexplained anemia during pregnancy, and highlights the need for immunological monitoring and a multidisciplinary approach to optimize maternal and fetal prognosis.
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