Kaneko Hiroto, Ohkawara Yasuo, Taniguchi Kouichi, Matsumoto Yousuke, Nomura Kenichi, Horiike Shigeo, Yokota Shouhei, Taniwaki Masafumi
Department of Hematology, Aiseikai-Yamashina Hospital, Kyoto Prefectural University of Medicine, Yamashina-ku, Japan.
Asian Pac J Allergy Immunol. 2006 Dec;24(4):245-8.
We report a 72-year-old female case of IgG-kappa type multiple myeloma (MM) simultaneously complicated with Sjögren syndrome (SS). She also presented marked hyperamylasemia of salivary-type isozyme. Although she had received sequential chemotherapy completed with high-dose therapy with autologous hematopoietic stem cell transplantation, she died of relapse fifteen months after the initial diagnosis. Various autoantibodies indicated that her sicca symptoms were due to true SS and not caused by MM cell infiltration to exocrine glands. MM cells appeared to produce amylase that fluctuated correspondingly to the disease status of MM. To our knowledge, this is the first English report of simultaneous complication of SS and MM referring to hyperamylasemia. Accumulation of this rare clinical manifestation is important to elucidate the pathogenesis of MM under condition of immunological disorder caused by SS.
我们报告一例72岁女性IgG-κ型多发性骨髓瘤(MM)同时合并干燥综合征(SS)的病例。她还表现出唾液型同工酶显著高淀粉酶血症。尽管她接受了序贯化疗并完成了大剂量治疗及自体造血干细胞移植,但在初诊后15个月死于复发。多种自身抗体表明她的干燥症状是由真正的SS引起,而非MM细胞浸润至外分泌腺所致。MM细胞似乎产生了与MM疾病状态相应波动的淀粉酶。据我们所知,这是首篇提及高淀粉酶血症的关于SS与MM同时并发的英文报道。积累这种罕见的临床表现对于阐明在SS引起的免疫紊乱情况下MM的发病机制很重要。