以鼻腔出血为首发症状的华氏巨球蛋白血症一例  

A case of Waldenström's macroglobulinemia with nasal hemorrhage as the initial symptom

作　　者：郭畅 闵汇刚 GUO Chang;MIN Huigang(Department of Neurology,CR&WISCO General Hospital Affiliated to Wuhan University of Science and Technology,Wuhan 430080,China;School of Medicine,Wuhan University of Science and Technology,Wuhan 430065,China)

机构地区：[1]武汉科技大学附属华润武钢总医院神经内科,武汉430080 [2]武汉科技大学医学部医学院,武汉430065

出　　处：《临床药物治疗杂志》2025年第2期90-92,共3页Clinical Medication Journal

摘　　要：本文报道1例合并症状性高黏血症华氏巨球蛋白血症(WM)患者的疾病特征、治疗策略及随访效果。患者因鼻腔出血10 d,牙龈出血半天入院,分析临床症状和体征,结合免疫电泳、骨髓病理、流式细胞学等检查确诊为WM,以血浆置换联合硼替佐米+地塞米松、利妥昔单抗+泽布替尼化疗。治疗和随访1年余,患者疗效为非常好的部分缓解。该病例为非专科医师对以皮肤黏膜出血为表现患者的诊断提供了新视角,对专科医师诊治合并高黏血症的WM提供参考。This article reported the clinical characteristics,treatment strategy,and follow-up efficacy of a patient with Waldenström′s macroglobulinemia(WM)complicated with symptomatic hyperviscosity syndrome.The patient was admitted to the hospital due to nasal bleeding for 10 days and gingival bleeding for half a day.The clinical symptoms and signs of the patient were analyzed,and the diagnosis of WM was confirmed by immunoelectrophoresis,bone marrow pathology and flow cytometry.Plasma exchange combined with bortezomib plus dexamethasone,rituximab and zebrutinib chemotherapy was performed.After treatment and follow-up for more than 1 year,the patient's curative effect was a very good partial response.This case provides a new perspective for non-specialists in the diagnosis of patients with mucocutaneous bleeding as the manifestation,and provides a clinical reference for specialists in the diagnosis and treatment of WM with hyperviscosity syndrome.

关 键 词：华氏巨球蛋白血症 高黏血症 出血 血浆置换 化疗 

分 类 号：R979.1[医药卫生—药品] R969.3[医药卫生—药学]