Brame Lori A, Dwivedi Rohit, Rice Todd W, Skierczynski Paul A
Indiana University School of Medicine, Division of Endocrinology, Emerson Hall 421, 545 Barnhill Drive, Indianapolis, IN 46202, USA.
Endocr Pract. 2003 May-Jun;9(3):225-8. doi: 10.4158/EP.9.3.225.
To describe a patient with hypercalcemia due to multiple myeloma and an associated atrial plasmacytoma.
A case report is presented with clinical and laboratory findings. We review the differential diagnosis of hypercalcemia and discuss multiple myeloma and plasmacytomas.
A 48-year-old woman presented to the emergency department with lethargy after sustaining trauma to the head. She was found to have a subdural hematoma and a parietal intraparenchymal hemorrhage. She had a serum calcium level of 17.2 mg/dL (normal, 8.4 to 10.6), anemia, thrombocytopenia, and renal insufficiency. Serum protein electrophoresis revealed a monoclonal gammopathy, and a bone marrow biopsy specimen was consistent with multiple myeloma. The patient required surgical evacuation of her subdural hematoma. Postoperatively, multiple complications developed, including a supraventricular tachycardia. She did not regain consciousness, and ventilatory support was withdrawn. On autopsy, she was found to have disseminated myeloma and an atrial plasmacytoma.
This case report emphasizes the need to consider a plasmacytoma as a manifestation of multiple myeloma when localizing symptoms are present.
描述一例因多发性骨髓瘤及相关心房浆细胞瘤导致高钙血症的患者。
呈现一份包含临床和实验室检查结果的病例报告。我们回顾了高钙血症的鉴别诊断，并讨论了多发性骨髓瘤和浆细胞瘤。
一名48岁女性因头部外伤后出现嗜睡症状就诊于急诊科。她被发现患有硬膜下血肿和顶叶脑实质内出血。她的血清钙水平为17.2mg/dL（正常范围为8.4至10.6），伴有贫血、血小板减少和肾功能不全。血清蛋白电泳显示单克隆丙种球蛋白病，骨髓活检标本与多发性骨髓瘤相符。该患者需要进行硬膜下血肿手术清除。术后出现了多种并发症，包括室上性心动过速。她未恢复意识，随后撤掉了通气支持。尸检时发现她患有播散性骨髓瘤和心房浆细胞瘤。
本病例报告强调，当出现局部症状时，需要考虑浆细胞瘤作为多发性骨髓瘤的一种表现形式。
