低龄多发性骨髓瘤一例并文献复习  

Multiple Myeloma in a 19-year-old Patient:Report of 1 Case and Review of Related Literatures

作　　者：肖广芬[1] 张聪明[1] 唐雪元[1] 姚晨娇[1] 孙剑[2] 

机构地区：[1]中南大学湘雅三医院血液科,湖南省长沙市410013 [2]中南大学湘雅三医院肾内科,湖南省长沙市410013

出　　处：《中国全科医学》2009年第18期1720-1722,共3页Chinese General Practice

摘　　要：目的提高对低龄多发性骨髓瘤的认识,减少其误诊率和漏诊率。方法分析1例19岁多发性骨髓瘤患者的实验室检查结果及治疗,并进行相关文献复习。结果患者首先表现为皮肤紫癜,血细胞沉降率明显增快,免疫球蛋白明显增高;后出现骨痛,放射性核素扫描全身骨显像示胸骨、肋骨、脊柱等多处骨质代谢异常;骨髓穿刺涂片显示大量异常原始浆细胞和幼稚浆细胞,成熟红细胞呈缗钱状分布。结论对于皮肤紫癜伴有血细胞沉降率明显增快、免疫球蛋白明显增高、不能用过敏性紫癜等引起紫癜的常见疾病解释者,即使是低龄患者,亦应警惕MM的可能性。Objective To distribute the knowledge of the features of Multiple Myeloma （MM） in young patients to reduce its misdiagnoses and missed diagnose rate. Methods Laboratory test results and the treatments of a 19 - year - old MM patient were analyzed, and related literatures were reviewed. Results The patient presented first with cutaneous purpura, with a marked elevation of erythroeyte sedimentation rate and increased immunoglobulin. And then ostalgia appeared, radionuclide scanning of total body bone showing sclcrotin metabolic disorders in many places such as sternum, ribs, spine bone, etc. Bone marrow smear showed a large number of abnormal primitive plasma cells and naive plasma ceils, mature red blood cells being in rouleanx - like distribution. Conclusion The possibility of MM should be emphasized when a patient, even if a young, has marked elevation of erythrocyte sedimentation rate, hyperproteinemia and inexplicable cutaneous purpura.

关 键 词：多发性骨髓瘤 误诊 诊断 鉴别 

分 类 号：R733.41[医药卫生—肿瘤]