多发性骨髓瘤合并原发性系统性轻链淀粉样变性周围神经病变1例  

A case report of multiple myeloma complicated with primary systemic light amyloidosis peripheral neuropa⁃thy

作　　者：吴春佳 张汉哲[2] 沈东辉 王海峰[2] 张维杰[2] 王新[2] WU Chunjia;ZHANG Hanzhe;SHEN Donghui;WANG Haifeng;ZHANG Weijie;WANG Xin(Qingdao Hospital,University of Health and Rehabilitation Sciences,Qingdao 266071,China)

机构地区：[1]潍坊医学院临床医学院,潍坊261053 [2]康复大学青岛医院(青岛市市立医院)神经内一科

出　　处：《中国神经精神疾病杂志》2023年第9期539-543,共5页Chinese Journal of Nervous and Mental Diseases

摘　　要：报告多发性骨髓瘤合并轻链型淀粉样变性周围神经病变1例。患者,男,60岁,亚急性起病,既往有高血压病、冠心病、稳定型心绞痛病史,2个月前尿常规检查示尿蛋白(+++),以双下肢进行性麻木无力的周围神经病变表现为首发临床症状,入院后完善肌电图、腰椎穿刺、肾穿刺、骨髓穿刺等相关检查后确诊,并给予相关治疗。本病作为神经系统罕见病,发病率较低,尽早诊断是降低病死率和改善预后的重要前提。然而该病极易误诊为糖尿病周围神经病变、慢性炎症性脱髓鞘性多发性神经根神经病,延误诊断和治疗。This paper reports a case of multiple myeloma complicated with Primary systemic light chain amyloidosis peripheral neuropathy.Patient was a male,60 years old with subacute onset of peripheral neuropathy.Patient had previous history of hypertension,coronary heart disease and stable angina pectoris.His urine routine examination 2 months ago showed urine protein(+++).The first clinical symptom with peripheral neuropathy characterized by progressive numbness and weakness of both lower limbs.The diagnosis was made after completing electromyography,lumbar puncture,renal puncture,bone puncture and other related examinations,and relevant treatment was given.As a rare disease of nervous system,the incidence rate is low.Early diagnosis is an important step to reduce mortality and improve prognosis.However,the disease is easily misdiagnosed as diabetic peripheral neuropathy and chronic inflammatory demyelinating polyradiculoneuropathy,thereby delaying diagnosis and treatment.

关 键 词：系统性原发性轻链淀粉样变性 系统性淀粉样变性 周围神经病变 多发性骨髓瘤 肌电图 

分 类 号：R745[医药卫生—神经病学与精神病学] R738.1[医药卫生—临床医学]