Beyler Kilic Ozlem, Oguz Ali Kemal, Ergun Ihsan, Baydar Dilek Ertoy, Ayli Meltem
Department of Internal Medicine, Ufuk University School of Medicine, 06520 Ankara, Turkey.
Division of Nephrology, Department of Internal Medicine, Ufuk University School of Medicine, 06520 Ankara, Turkey.
Case Rep Nephrol. 2015;2015:635974. doi: 10.1155/2015/635974. Epub 2015 May 21.
Nonsecretory multiple myeloma (NSMM) is the absence of a detectable monoclonal protein in serum and urine of a multiple myeloma (MM) patient and immunoglobulin light chain (AL) amyloidosis is a significantly rare complication. A case of NSMM with AL amyloidosis and nephrotic range proteinuria is presented. Sharing clinical, therapeutic, and prognostic characteristics with MM, real challenge may be during initial diagnosis of NSMM and assessment of treatment response. In elderly patients with unexplained renal dysfunction, MM should be in the differential diagnosis and the absence of a monoclonal protein should not rule out MM but should remind us of the possibility of NSMM.
非分泌型多发性骨髓瘤（NSMM）是指多发性骨髓瘤（MM）患者的血清和尿液中未检测到单克隆蛋白，而免疫球蛋白轻链（AL）淀粉样变性是一种极为罕见的并发症。本文报告了一例合并AL淀粉样变性和肾病范围蛋白尿的NSMM病例。NSMM与MM具有相同的临床、治疗和预后特征，真正的挑战可能在于NSMM的初始诊断和治疗反应评估。对于不明原因肾功能不全的老年患者，MM应列入鉴别诊断，单克隆蛋白的缺失不应排除MM，而应提醒我们存在NSMM的可能性。
