Alcalay M, Gombert J, Frocrain C, Bontoux D
Sem Hop. 1975 Apr 14;51(18):1227-34.
The authors report the case of a 72 year old man admitted to hospital for thoracic pain, who was found to have an Igd myeloma of lambda type. The diagnosis, suspected, in view of anemia, raised sedimentation rate and abnormal electrophoresis of serum proteins, was confirmed by marrow examination after sternal aspiration and by the use of a specific anti-serum during immuno-electrophoresis and on Ouchteriony medium. There were radiological lesions of diffuse, decalcifying myelomatous type. The course was characterised by : 1) a constant tendency to anemia, then preterminal thrombocytopenia, whereas the leukopenia remained moderate. 2) The secondary onset of Bence-Jones proteinuria and mild albuminuria with the aggravation of pre-existing renal failure. 3) Repeated attacks of infection and the intermittent onset of mental confusion, the etiology of which was not clear. Death occurred ten months later. No autopsy was carried out. In the light of this case, the authors review the world literature and the special characteristics of IgD myeloma.
作者报告了一例因胸痛入院的72岁男性病例，该患者被发现患有λ型IgD骨髓瘤。鉴于贫血、血沉加快和血清蛋白电泳异常而怀疑的诊断，通过胸骨穿刺后的骨髓检查以及免疫电泳和欧氏平板上使用特异性抗血清得以证实。存在弥漫性脱钙骨髓瘤类型的放射学病变。病程特点为：1）持续存在贫血倾向，随后是终末期前血小板减少，而白细胞减少仍属中度。2）随着原有肾衰竭的加重，继发本-周氏蛋白尿和轻度白蛋白尿。3）反复感染发作以及间歇性精神错乱，其病因不明。十个月后死亡。未进行尸检。鉴于该病例，作者回顾了世界文献以及IgD骨髓瘤的特殊特征。
