特立帕肽治疗并发恶性骨髓瘤。
Teriparatide treatment complicated by malignant myeloma.
作者信息
Koski Anna-Mari, Sikiö Anu, Forslund Terje
机构信息
Division of Endocrinology, Department of Medicine, Central Finland Health Care District Hospital Jyväskylä, Jyväskylä, Finland.
出版信息
BMJ Case Rep. 2010 Aug 13;2010:bcr0120102681. doi: 10.1136/bcr.01.2010.2681.
Recombinant human parathyroid hormone (1-34) (rhPTH 1-34), teriparatide (Forsteo in Europe), is a new compound that has been introduced and shown to be successful in the treatment of osteoporosis. The mechanisms of action include a pulsative influence on the RANKL/OPG system resulting in osteoblast activation and increased bone formation by teriparatide. In malignant myeloma there is an imbalance between osteoclast and osteoblast activity with involvement of the RANKL/OPG system among others. We report a case with monoclonal gammopathy of uncertain significance (MGUS) who developed malignant myeloma after teriparatide treatment and we suggest that in addition to malignant myeloma and smouldering myeloma, MGUS should also be considered contraindicated for teriparatide treatment.
重组人甲状旁腺激素（1-34）（rhPTH 1-34），即特立帕肽（在欧洲为福斯高林），是一种已被引入且已证明在治疗骨质疏松症方面取得成功的新化合物。其作用机制包括对RANKL/OPG系统产生脉冲式影响，从而导致成骨细胞活化，并使特立帕肽增加骨形成。在恶性骨髓瘤中，破骨细胞和成骨细胞活性之间存在失衡，RANKL/OPG系统等也参与其中。我们报告了1例意义未明的单克隆丙种球蛋白病（MGUS）患者，该患者在接受特立帕肽治疗后发生了恶性骨髓瘤，并且我们建议，除了恶性骨髓瘤和冒烟型骨髓瘤外，MGUS也应被视为特立帕肽治疗的禁忌证。
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