Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida 33612, USA.
Am J Med Sci. 2010 Jan;339(1):81-2. doi: 10.1097/MAJ.0b013e3181b61145.
We report a case of a 57-year-old African American male patient with standard risk (IIIA) IgA kappa multiple myeloma. This patient presented with neurologic complaints (manifesting as generalized muscle weakness and swallowing dysfunction associated with a poor cough reflex) 10 months after achieving a very good partial remission and without evidence of systemic progression. Examination of the cerebrospinal fluid revealed leptomeningeal involvement. Very little is known about the mechanisms of myelomatous spread to the leptomeninges, a very rare event, and the presentation of this case could raise awareness of this rare complication in those involved in caring for patients with multiple myeloma.
我们报告了一例 57 岁的非裔美国男性患者，患有标准风险（IIIA）IgA 卡氏多发性骨髓瘤。该患者在获得非常好的部分缓解后 10 个月出现神经症状（表现为全身肌肉无力和吞咽功能障碍，以及咳嗽反射不良），且无全身进展的证据。对脑脊液的检查显示软脑膜受累。多发性骨髓瘤向软脑膜扩散的机制鲜为人知，这是一种非常罕见的事件，本例的表现可能会引起那些参与多发性骨髓瘤患者治疗的人的警惕，认识到这种罕见并发症的存在。
