以腹泻为主的华氏巨球蛋白血症1例并文献复习  

Diarrhea as the principal presentation of Waldenstrom macroglobulinemia:a case report and literature review

作　　者：安雯 黄刚 于岩波[2] 左秀丽[2] 李延青[2] AN Wen;HUANG Gang;YU Yanbo;ZUO Xiuli;LI Yanqing(Cheeloo College of Medicine,Shandong University,Jinan 250012,Shandong,China;Department of Gastroenterology,Qilu Hospital of Shandong University,Jinan 250012,Shandong,China)

机构地区：[1]山东大学齐鲁医学院,山东济南250012 [2]山东大学齐鲁医院消化内科,山东济南250012

出　　处：《山东大学学报（医学版）》2022年第8期84-90,共7页Journal of Shandong University:Health Sciences

基　　金：国家自然科学基金(81873550,81670486)

摘　　要：目的提高临床医生对华氏巨球蛋白血症消化道受累的认识。方法报告1例慢性腹泻伴体质量减轻最终诊断为华氏巨球蛋白血症病例,回顾文献讨论该病累及消化道的特点。结果报告1例华氏巨球蛋白血症明显胃肠道受累的病例,表现为慢性腹泻伴体质量减轻和低蛋白血症。小肠活检淀粉样变阴性。患者接受利妥昔单抗联合苯达莫司汀治疗腹泻很快缓解。检索文献回顾性分析华氏巨球蛋白血症与消化道症状的关联。结论提高对华氏巨球蛋白血症胃肠道表现的认识可能有助于解释和治疗这种惰性、潜在危及生命的淋巴系统恶性疾病。Objective To enhance clinician’s understanding of the involvement of gastrointestinal tract in Waldenstrom macroglobulinemia(WM).Methods A case of chronic diarrhea with weight loss diagnosed as WM was reported.Relevant literature was reviewed.Results The WM case was associated with significant gastrointestinal involvement,manifested as chronic diarrhea with weight loss and hypoproteinemia.Small bowel biopsy was negative for amyloidosis.Rituximab in combination with bendamustine soon relieved the diarrhea.Literature about the association of WM with gastrointestinal symptoms was reviewed.Conclusion An increased awareness of the gastrointestinal manifestations of WM may help to explain and treat the indolent,potentially life-threatening lymphatic malignancy.

关 键 词：华氏巨球蛋白血症 腹泻 低蛋白血症 体质量减轻 

分 类 号：R733.1[医药卫生—肿瘤]