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[一名患有与肾淀粉样变性和急性肾衰竭相关的IgD骨髓瘤的老年患者]

[An elderly patient with IgD myeloma associated with renal amyloidosis and acute renal failure].

作者信息

Kiyatake I, Tomino Y, Funabiki K, Kubokawa Y, Shirato I, Kubota M, Koide H

出版信息

Nihon Jinzo Gakkai Shi. 1989 Jul;31(7):791-6.

PMID:2511365
Abstract

A 83-year-old male patient with IgD myeloma associated with renal amyloidosis and acute renal failure is described. We also reviewed the clinicopathological findings of IgD myeloma in the literature. Although hemodialysis was performed 36 times for acute renal failure, he died of severe gastrointestinal bleeding. Renal necropsy specimens revealed typical features of amyloidosis in light microscopic, electron microscopic and immunofluorescent examinations. The levels of serum IgD (755 mg/dl), immunoelectrophoresis, and immunofluorescence of bone marrow and renal specimens were consistent with IgD myeloma (lambda type). IgD myeloma is generally considered to be a rare disease of juvenile onset and is complicated with extramyelogenic tumors according to previous reports. However, IgD myeloma without extramyelogenic tumors occurred in a 83-year-old patient reported here. It appears that advanced age onset IgD myeloma associated with renal amyloidosis and acute renal failure is rare. This was the oldest case of IgD myeloma we examined.

摘要

本文描述了一位83岁的男性患者,患有与肾淀粉样变性和急性肾衰竭相关的IgD骨髓瘤。我们还回顾了文献中IgD骨髓瘤的临床病理特征。尽管因急性肾衰竭进行了36次血液透析,但他最终死于严重的胃肠道出血。肾脏尸检标本在光学显微镜、电子显微镜和免疫荧光检查中显示出淀粉样变性的典型特征。血清IgD水平(755mg/dl)、免疫电泳以及骨髓和肾脏标本的免疫荧光结果均与IgD骨髓瘤(λ型)相符。IgD骨髓瘤通常被认为是一种罕见的青少年发病疾病,根据以往报道,常并发髓外肿瘤。然而,本文报道的一位83岁患者患有无髓外肿瘤的IgD骨髓瘤。看来,与肾淀粉样变性和急性肾衰竭相关的高龄发病IgD骨髓瘤较为罕见。这是我们所研究的IgD骨髓瘤患者中年龄最大的病例。

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