Lautzenhiser Sarah J, Walker Mark C, Goring Robert L
Affiliated Veterinary Specialists, Orange Park, P.A., 275 Corporate Way, Ste 100, Orange Park, FL 32073, USA.
J Am Vet Med Assoc. 2003 Sep 1;223(5):645-8, 636. doi: 10.2460/javma.2003.223.645.
A 4-year-old castrated male dog was evaluated because of multiple-limb lameness. Signs of pain were elicited during palpation of the regions of the proximal tibial metaphyses and distal left radial diaphysis. Radiography revealed osteolytic lesions of the long bones. Blood analyses revealed hypercalcemia and transient cytopenias. Serum protein electrophoresis did not reveal a monoclonal gammopathy; however, urine protein electrophoresis revealed Bence Jones proteinuria. Serial diagnostic sampling of bone lesions, immunohistochemical staining methods, and serum and urine protein immunoelectrophoresis were required to establish a diagnosis of multiple myeloma. Two IgM components were identified via serum protein immunoelectrofixation. The dog improved clinically after initiation of chemotherapy with melphalan and prednisone; however, the dog ultimately was euthanatized because of pathologic fracture. The case was unique because there was lack of vertebral involvement, an unusual gammopathy, and difficulty in identifying myeloma cells via serial sampling.
一只4岁去势雄性犬因多肢跛行接受评估。在触诊胫骨近端干骺端区域和左桡骨远端骨干时引发疼痛迹象。放射检查显示长骨有溶骨性病变。血液分析显示高钙血症和短暂血细胞减少。血清蛋白电泳未显示单克隆丙种球蛋白病;然而,尿蛋白电泳显示本周蛋白尿。需要对骨病变进行系列诊断采样、免疫组织化学染色方法以及血清和尿蛋白免疫电泳来确诊多发性骨髓瘤。通过血清蛋白免疫电固定鉴定出两种IgM成分。该犬在开始使用美法仑和泼尼松进行化疗后临床症状有所改善;然而,这只犬最终因病理性骨折而实施安乐死。该病例独特之处在于缺乏椎体受累、存在不寻常的丙种球蛋白病以及通过系列采样难以识别骨髓瘤细胞。