Hirota Yusuke, Suzuki Shingo, Katsuyama Yota, Iseki Tohru, Ikusaka Masatomi
Department of General Medicine, Chiba University Hospital, Japan.
Department of Transfusion Medicine and Cell Therapy, Chiba University Hospital, Japan.
Intern Med. 2017;56(13):1725-1727. doi: 10.2169/internalmedicine.56.8158. Epub 2017 Jul 1.
A 60-year-old man was referred to us with high levels of aspartate aminotransferase and lactate dehydrogenase (LDH). He did not complain of any symptoms; however, he had been diagnosed with lumbar disc herniation, even though his back pain improved only to half of its previous level with pregabalin. Thus, we asked about the red flag of back pain and confirmed that he had involuntary body weight loss, which led us to diagnose truly non-secretory multiple myeloma, a variant of multiple myeloma that is associated with M-protein negativity and a normal serum free light chain level.
一名60岁男性因天冬氨酸转氨酶和乳酸脱氢酶（LDH）水平升高前来我院就诊。他没有任何症状主诉；然而，他曾被诊断为腰椎间盘突出症，尽管服用普瑞巴林后背痛仅减轻至之前水平的一半。因此，我们询问了背痛的警示信号，确认他存在非自愿体重减轻，这使我们诊断其为真正的非分泌型多发性骨髓瘤，这是多发性骨髓瘤的一种变体，与M蛋白阴性和血清游离轻链水平正常有关。
