Bechir Achour, Haifa Regaieg, Nesrine Ben Sayed, Emna Bouslema, Senda Mejdoub, Asma Achour, Amina Bouatay Bouzouita, Mrabet Senda, Yosra Ben Youssef, Mondher Kortas, Abderrahim Khelif
Department of Hematology, Farhat Hached Hospital, Sousse Tunisia.
Department of Radiology, Farhat Hached Hospital, Sousse Tunisia.
Pan Afr Med J. 2016 Nov 1;25:127. doi: 10.11604/pamj.2016.25.127.10750. eCollection 2016.
Auto-immun events are rare in multiple myeloma (MM). Here, we report one MM case complicated by Evans syndrome (Autoimmun hemolytic anemia (AIHA) associated with thrombocytopenia). A 52-year-old man was admitted in nephrology department with severe anemia, renal insufficiency and hypergamma globulinemia. Laboratory exams showed acute hemolysis due to an IgG warm autoantibody. Serum electrophoresis revealed the presence of a monoclonal IgG protein and urinary M protein was 2g/day. A whole body CT-Scan showed osteolytic lesions of vertebral body of C5, D4, L3, L4 and the left iliac wing. The diagnosis of multiple myeloma and Evan's syndrome was made, we underwent chemotherapy by BTD (bortezomib-thalidomide-dexamethasone) and continuous corticosteroid therapy but unfortunately the patient died secondary of a Lactic acidosis. The relationship between MM and hemolysis remain unclear.
自身免疫事件在多发性骨髓瘤（MM）中较为罕见。在此，我们报告一例并发伊文氏综合征（自身免疫性溶血性贫血（AIHA）合并血小板减少症）的MM病例。一名52岁男性因严重贫血、肾功能不全和高球蛋白血症入住肾内科。实验室检查显示因IgG温抗体导致急性溶血。血清电泳显示存在单克隆IgG蛋白，尿M蛋白为2g/天。全身CT扫描显示C5、D4、L3、L4椎体及左髂骨翼有溶骨性病变。诊断为多发性骨髓瘤和伊文氏综合征，我们采用硼替佐米-沙利度胺-地塞米松（BTD）进行化疗及持续皮质类固醇治疗，但不幸的是，患者因乳酸性酸中毒继发死亡。MM与溶血之间的关系仍不清楚。
