CAJ | 학술논문

目的探讨强直性脊柱炎(AS)合并多发性骨髓瘤(MM)的临床特点及潜在机制.方法报道3例AS合并MM患者临床资料,结合文献复习对临床特点、潜在机制、诊治要点进行探讨.结果患者在处于较长时间AS症状静止期后发生MM,表现为持续、剧烈的腰背痛或关节痛,易发生病理性骨折,伴血液、肾脏、神经系统损害等,对非甾体抗炎药不敏感,预后差.结论长程AS患者病情处于较长时间静止期后症状再次反复,伴有病理性骨折、贫血、反复感染、蛋白尿、红细胞沉降率明显增快、免疫球蛋白异常增高及全身症状等表现时,常规疗效差者,要警惕MM可能.
목적 탐토강직성척주염(AS)합병다발성골수류(MM)적림상특점급잠재궤제.방법 보도3례AS합병MM환자림상자료,결합문헌복습대림상특점、잠재궤제、진치요점진행탐토.결과 환자재처우교장시간AS증상정지기후발생MM,표현위지속、극렬적요배통혹관절통,역발생병이성골절,반혈액、신장、신경계통손해등,대비치체항염약불민감,예후차.결론 장정AS환자병정처우교장시간정지기후증상재차반복,반유병이성골절、빈혈、반복감염、단백뇨、홍세포침강솔명현증쾌、면역구단백이상증고급전신증상등표현시,상규료효차자,요경척MM가능.
Objective To investigate the pathogenesis and clinical features of ankylosing spondylitis (AS) concurrent with multiple myeloma (MM).Methods The clinical characteristics,pathogenesis,diagnosis and treatment of 3 cases who were diagnosed as AS concurrent with MM were analyzed and relevant literatures were reviewed.Results MM was confirmed in patients who had long-term stable AS.A wide variety of manifestations,including persistent pain in spine and thorax,pathologic fracture,anemia,kidney damage and nervous system abnormalities were frequently presented.These patients were insensitive to nonsteroidal anti-inflammatory drug treatment,and they had a unfavorable prognosis.Conclusion Patients who are diagnosed as AS concurrent with MM can present with a variety of clinical features.Manifestations which are difficult to explain clinically by AS and poor response to treatment especially when the patients have longterm stable AS are potential clues for MM.