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多发性骨髓瘤伴广泛纤维化和浆细胞浸润的门静脉高压症。

Portal hypertension with extensive fibrosis and plasma cell infiltration in multiple myeloma.

机构信息

Reims Teaching Hospitals, Robert-Debré Hospital, Department of Internal Medicine, Infectious Diseases, and Clinical Immunology, 51092 Reims, France.

Reims Teaching Hospitals, Robert-Debré Hospital, Pathology Department, 51092 Reims, France.

出版信息

Clin Res Hepatol Gastroenterol. 2016 Dec;40(6):e71-e73. doi: 10.1016/j.clinre.2016.04.007. Epub 2016 Jun 21.

Abstract

Plasma cell infiltration of the liver has been described in about 45% of patient with multiple myeloma in autopsy review; however, it is usually not associated with significant liver dysfunction. Indeed, only rare cases of massive plasma cell infiltration leading to non-obstructive cholestasis and hepatic failure have been described. Here, we report a case with a history of 8 years of MM with extensive liver fibrosis and portal hypertension with no other evidence aetiology unless massive plasma cell infiltration who presented a significant regression of both biological liver abnormalities and liver stiffness after ten months of chemotherapy concomitantly to a significant decrease of the IgG serum monoclonal band.

摘要

尸检研究显示,约 45%的多发性骨髓瘤患者存在肝浆细胞浸润;然而,通常不会伴有显著的肝功能障碍。事实上,仅有少数情况下会出现大量浆细胞浸润导致非梗阻性胆汁淤积和肝衰竭的病例。在此,我们报告了一例多发性骨髓瘤病史 8 年的患者,其存在广泛的肝纤维化和门静脉高压,无其他病因学证据,除非存在大量浆细胞浸润,否则患者在接受十个月的化疗后同时伴有 IgG 血清单克隆带的显著减少,其肝脏生物异常和肝硬度均显著消退。

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