Komiya I, Ito T, Ogata K, Yamada T, Dan K Z, Kuriya S, Nomura T
Third Department of Internal Medicine, Nippon Medical School.
Rinsho Ketsueki. 1990 Jan;31(1):62-5.
A 58-year-old female was referred to us because of M-proteinemia and anemia. Bone marrow showed normal cellularity with 14.8% of atypical plasma cells. Serum electrophoresis on cellulose acetate membrane revealed a single M-peak (56.9%). Immunoelectrophoresis showed large M-bows against anti-IgA and anti-lambda, together with small M-bows against anti-IgG and anti-kappa of the same electrophoretic mobility. In the urine, lambda type Bence Jones protein was found. The skull X-ray showed multiple punched out lesions. APTT was 61 seconds, fibrinogen 118 mg/dl, factor VIII clotting activity 25% with normal factor VIII related antigen, and factor IX clotting activity 38%. Circulating anticoagulants were not detected. These hemostatic abnormalities were thought ascribable to the interference of clotting activities by paraproteins. On the 33rd hospital day, she suffered from intracerebral hemorrhage, which was possibly due to these hemostatic abnormalities.
一名58岁女性因M蛋白血症和贫血前来我院就诊。骨髓检查显示细胞数量正常，非典型浆细胞占14.8%。醋酸纤维素膜血清电泳显示单一M峰（56.9%）。免疫电泳显示针对抗IgA和抗λ有大的M弓，同时针对抗IgG和抗κ有相同电泳迁移率的小M弓。尿液中发现λ型本-周蛋白。颅骨X线显示多个穿凿样病变。活化部分凝血活酶时间（APTT）为61秒，纤维蛋白原118mg/dl，因子VIII凝血活性25%，因子VIII相关抗原正常，因子IX凝血活性38%。未检测到循环抗凝物质。这些止血异常被认为是副蛋白干扰凝血活性所致。住院第33天，她发生了脑出血，可能是由于这些止血异常。
