Park So Young, Kim Jae Min, Kang Hyun Joon, Kim Minje, Han Jae Joon, Maeng Chi Hoon, Baek Sun Kyung, Yoon Hwi-Joong, Kim Si-Young, Kim Hyo Jong
Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
Department of Internal Medicine, Graduate School, Kyung Hee University, Seoul, Korea.
Intest Res. 2017 Apr;15(2):249-254. doi: 10.5217/ir.2017.15.2.249. Epub 2017 Apr 27.
Crohn's disease (CD) is a chronic inflammatory bowel disease (IBD) that presents with abdominal pain, weight loss, and diarrhea. Although the etiology has not been fully elucidated, both environmental and genetic causes are known to be involved. In chronic inflammatory conditions such as IBD, B lymphocytes are chronically stimulated, and they induce monoclonal expansion of plasma cells, sometimes resulting in monoclonal gammopathy of undetermined significance. Immunomodulators that are commonly used to control inflammation, such as tumor necrosis factor-α (TNF-α) blockers could increase the possibility of hematologic malignancy. The pathogenesis of multiple myeloma in association with TNF-α inhibitor therapy is attributed to decreased apoptosis of plasma cell populations. Here, we describe a case of a 36-year-old male patient who was diagnosed with immunoglobulin A subtype smoldering multiple myeloma during the treatment for CD with infliximab and adalimumab. We report this case along with a review of the literature on cases of multiple myeloma that occurred in conjunction with CD.
克罗恩病（CD）是一种慢性炎症性肠病（IBD），表现为腹痛、体重减轻和腹泻。尽管其病因尚未完全阐明，但已知环境因素和遗传因素都与之相关。在诸如IBD这样的慢性炎症状态下，B淋巴细胞受到慢性刺激，它们诱导浆细胞单克隆扩增，有时会导致意义未明的单克隆丙种球蛋白病。常用的控制炎症的免疫调节剂，如肿瘤坏死因子-α（TNF-α）阻滞剂，可能会增加血液系统恶性肿瘤的发生可能性。与TNF-α抑制剂治疗相关的多发性骨髓瘤的发病机制归因于浆细胞群体凋亡减少。在此，我们描述了一名36岁男性患者的病例，该患者在使用英夫利昔单抗和阿达木单抗治疗CD期间被诊断为免疫球蛋白A亚型冒烟型多发性骨髓瘤。我们报告该病例并回顾关于与CD相关的多发性骨髓瘤病例的文献。
