Masanés F, Pedrol E, Bladé J, Casademont J, de la Sierra A, Martínez-Orozco F, Grau J M, Ingelmo M
Servicio de Medicina Interna, General Hospital Clínic i Provincial, Barcelona.
Med Clin (Barc). 1991 May 25;96(20):777-9.
The IgM myeloma is a rare type of multiple myeloma (MM) with some features which differentiate it from other immunologic types of myeloma and from Waldenström macroglobulinemia (WM). Two patients with IgM myeloma in whom the only clinical feature of the disease was the development of bone lesions and general deterioration are reported. In none of the cases an M component was detected in proteinogram. A bone marrow proliferation of plasma cells was discovered in both, which it was accompanied with dura mater infiltration in one of them. The type of secreted immunoglobulin was IgM lambda in the first case and kappa in the second. Both patients had a poor clinical course after the diagnosis and died due to infective complications. Emphasis is made on the need to differentiate this condition from WM due to their different prognosis and therapy.
IgM型骨髓瘤是一种罕见的多发性骨髓瘤(MM),具有一些使其有别于其他免疫类型骨髓瘤以及华氏巨球蛋白血症(WM)的特征。本文报道了两名IgM型骨髓瘤患者,该病唯一的临床特征是出现骨病变和全身状况恶化。两例患者的蛋白电泳均未检测到M成分。二者均发现浆细胞在骨髓中增殖,其中一例伴有硬脑膜浸润。第一例分泌的免疫球蛋白类型为IgM λ,第二例为κ。两名患者确诊后的临床病程均较差,死于感染性并发症。鉴于其不同的预后和治疗方法,强调了将这种情况与WM相鉴别的必要性。