一名多发性骨髓瘤患者的不对称性深层基质角膜病变
Asymmetric Deep Stromal Keratopathy in a Patient With Multiple Myeloma.
作者信息
Tainsh Laurel T, Coady Patrick A, Sinard John H, Neparidze Natalia, Meskin Seth W, Adelman Ron A, Chow Jessica
机构信息
*Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, CT; †New England Retina Associates, Hamden, CT; and Departments of ‡Pathology; and §Medicine, Yale University School of Medicine, New Haven, CT.
出版信息
Cornea. 2017 Mar;36(3):372-374. doi: 10.1097/ICO.0000000000001139.
PURPOSE
To report a case of asymmetric deep stromal keratopathy in a patient with multiple myeloma.
METHODS
Case report and literature review.
RESULTS
An 85-year-old woman was found to have progressive visually significant left-sided deep stromal opacity in the setting of monoclonal gammopathy. Hematologic workup resulted in a diagnosis of IgG kappa multiple myeloma. Histopathology was significant for semicrystalline deposits in the posterior stroma. The patient's visual acuity improved to 20/50 7 months after penetrating keratoplasty. A similar deep stromal lesion appeared in the right eye 2 years after initial presentation.
CONCLUSIONS
We present an unusual case of paraproteinemic keratopathy with a uniquely asymmetric presentation that resulted in a diagnosis of multiple myeloma.
目的
报告一例多发性骨髓瘤患者发生的不对称性深层基质性角膜病变。
方法
病例报告及文献复习。
结果
一名85岁女性在单克隆丙种球蛋白病背景下出现进行性、有明显视力影响的左侧深层基质混浊。血液学检查诊断为IgG κ型多发性骨髓瘤。组织病理学显示后基质中有半结晶沉积物。穿透性角膜移植术后7个月，患者视力提高到20/50。初次发病2年后，右眼出现类似的深层基质病变。
结论
我们报告了一例不寻常的副蛋白血症性角膜病变，其表现独特且不对称，最终诊断为多发性骨髓瘤。
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