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[双侧胸膜炎揭示伴有游离轻链的骨髓瘤并合并骨直链淀粉]

[Bilateral pleurisy revealing a myelome with free light chains complicated with an osseous amylose].

作者信息

El Boukhrissi Fatima, Balouch Lhousaine, Hachimi Moulay Ahmed, Hommadi Abdelaziz, Idrissi My Mustapha Rguibi, Bamou Youssef

机构信息

Hôpital Militaire Moulay Ismail, Service de Biochimie-Toxicologie, Meknès, Maroc.

出版信息

Ann Biol Clin (Paris). 2011 Sep-Oct;69(5):593-6. doi: 10.1684/abc.2011.0621.

Abstract

The osseous amyloidosis associated with a pleural effusion in a myeloma is a rare situation. We report a case of an association of these three disease entities for discussion. A 75-year-old man was admitted for chest pain and dyspnea with left sacred bone pain. The radiological assessment reported pleurisy and bilateral lytic images of the sacrum with soft tissue invasion, the biochemical tests showed a lambda free light chain myeloma and bone biopsy reported amyloidosis. The occurrence of systemic amyloidosis in myeloma is well documented, but the osseous location is rare and rarely revealed. Pleural effusion is a known complication of myeloma but is exceptionally revealing; it is usually seen in the myeloma IgG and IgA but very rarely in free light chain myeloma. We reported here a case that represents an exceptional situation of complications of light chains myeloma to remember their possible occurrence and to insist for the clinician sensitizing to carry out investigations on time and avoid complications or at minimum to retard them.

摘要

骨髓瘤伴胸腔积液的骨淀粉样变性是一种罕见情况。我们报告一例这三种疾病实体相关联的病例以供讨论。一名75岁男性因胸痛、呼吸困难伴左侧骶骨疼痛入院。影像学评估报告有胸膜炎以及双侧骶骨溶骨性影像伴软组织侵犯,生化检查显示λ游离轻链骨髓瘤,骨活检报告为淀粉样变性。骨髓瘤中系统性淀粉样变性的发生已有充分记录,但骨部位罕见且很少被发现。胸腔积液是骨髓瘤已知的并发症,但极少具有提示性;通常见于骨髓瘤IgG和IgA型,而在游离轻链骨髓瘤中非常罕见。我们在此报告一例代表轻链骨髓瘤并发症特殊情况的病例,以记住其可能的发生情况,并强调临床医生要及时进行检查,避免并发症或至少延缓其发生。

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