CAJ | 학술논문

目的：报告1例以神经系统病变为首发症状，合并肾功能衰竭及骨质增生的多发性骨髓瘤病例。方法回顾性分析多发性骨髓瘤患者的临床表现、骨髓活检结果、诊疗经过，结合复习文献对多发性骨髓瘤临床特点、诊断标准进行探讨。结果本病例为中年女性，临床表现为四肢关节疼痛伴进行性肌萎缩、无力6个月，伴贫血、高钙、肾功能衰竭及骨质增生。血、尿轻链测定示K、L链明显异常；尿蛋白电泳见单峰突起的M蛋白；骨髓涂片示浆细胞系统异常增生，原幼浆细胞占46.8%。结论对40岁以上患者出现神经系统症状，合并骨痛、贫血以及严重脏器损害时要考虑多发性骨髓瘤可能。骨髓细胞学和尿血蛋白电泳检查可明确诊断。
목적：보고1례이신경계통병변위수발증상，합병신공능쇠갈급골질증생적다발성골수류병례。방법회고성분석다발성골수류환자적림상표현、골수활검결과、진료경과，결합복습문헌대다발성골수류림상특점、진단표준진행탐토。결과본병례위중년녀성，림상표현위사지관절동통반진행성기위축、무력6개월，반빈혈、고개、신공능쇠갈급골질증생。혈、뇨경련측정시K、L련명현이상；뇨단백전영견단봉돌기적M단백；골수도편시장세포계통이상증생，원유장세포점46.8%。결론대40세이상환자출현신경계통증상，합병골통、빈혈이급엄중장기손해시요고필다발성골수류가능。골수세포학화뇨혈단백전영검사가명학진단。
Aim TA patient who had multiple myeloma (MM) with neuropathy as an initial symptom associated with renal failure and hyperosteogeny was described. Methods A case diagnosed as multiple myeloma was reported and the characteristics of multiple myeloma were reviewed. Results The patient developed arthralgia and muscular atrophy, weakness, anaemia, hypercalcemia, renal failure. And hyperosteogeny also happened in the course of disease. M proteins (free light-chain, dominantλ-chain) were found in serum and urine. An IgM spike was identiifed on UPEP. More than 46.8%plasma cells were found in the bone marrow. Conclusion For patients of more than 40 years older with neurological symptoms, bone ache, anaemia, and severe organ damages, MM should be taken into consideration, meanwhile bone marrow cytology and UPEP should be needed for diagnosis.