双侧结晶状角膜沉积物作为单克隆丙种球蛋白病的首发临床表现：一例报告
Bilateral crystalline corneal deposits as first clinical manifestation of monoclonal gammopathy: a case report.
作者信息
Steinberg Johannes, Eddy Mau-Thek, Katz Toam, Matthiessen Eike, Fricke Otto H, Richard Gisbert, Linke Stephan J
机构信息
Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
出版信息
Case Rep Ophthalmol. 2011 May;2(2):222-7. doi: 10.1159/000330334. Epub 2011 Jul 26.
AIMS
To report the clinical and diagnostic findings of a patient with bilateral corneal deposits caused by an underlying monoclonal gammopathy.
METHODS
Slit-lamp biomicroscopy, confocal microscopy and additional serological tests were performed on a 35-year-old man presenting with bilateral crystalline corneal deposits.
RESULTS
The patient was diagnosed as having monoclonal gammopathy based on elevated levels of serum immunoglobulin G. Confocal microscopy showed highly reflective (protein) deposits throughout the entire cornea, with the highest density in the epithelium and anterior stromal keratocytes.
CONCLUSIONS
Monoclonal gammopathy, a potential sign of a life-threatening disease, can lead to dense, bilateral corneal deposits. As such changes can occur long before ocular or systemic discomforts appear, an early diagnosis is crucial. Ophthalmologists should be aware of corneal deposits as potential warning signs of monoclonal gammopathy.
目的
报告一例由潜在单克隆丙种球蛋白病引起双侧角膜沉积物患者的临床及诊断结果。
方法
对一名出现双侧晶状体性角膜沉积物的35岁男性进行裂隙灯生物显微镜检查、共聚焦显微镜检查及其他血清学检查。
结果
基于血清免疫球蛋白G水平升高，该患者被诊断为单克隆丙种球蛋白病。共聚焦显微镜检查显示整个角膜均有高反射性（蛋白质）沉积物，上皮层和前基质角膜细胞中密度最高。
结论
单克隆丙种球蛋白病是一种危及生命疾病的潜在迹象，可导致双侧角膜致密沉积物。由于此类变化可在眼部或全身不适出现之前很久就发生，早期诊断至关重要。眼科医生应将角膜沉积物视为单克隆丙种球蛋白病的潜在警示信号。
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