Paul Rudrajit, Ruia Aditya V, Saha Asim, Mondal Jayati, Sau T J, Thakur Indranil, Haldar Kunal
Department of Medicine, Kolkata Medical College, Kolkata, West Bengal, India.
Department of Gynaecology, Chittaranjan Seva Sadan Hospital, Kolkata, West Bengal, India.
Sultan Qaboos Univ Med J. 2017 May;17(2):e221-e224. doi: 10.18295/squmj.2016.17.02.015. Epub 2017 Jun 20.
Multiple myeloma (MM) can present with involvement of the central nervous system in the form of nerve palsy, plasma cell masses or, rarely, with endocrinological effects due to involvement of the pituitary gland. Usually, in such cases, the disease has a rapid progression and poor prognosis. We report a 52-year-old man who was admitted to the Kolkata Medical College, Kolkata, India, in 2016 with a prolonged low-grade fever and hypernatremia. Shortly afterwards, the patient began to complain of increased urinary frequency and drowsiness. The hypernatremia was treated with intranasal desmopressin and free water replacement. Serum protein electrophoresis and an immunofixation study revealed an immunoglobulin G-κ monoclonal band. Magnetic resonance imaging of the pituitary gland revealed the absence of a posterior bright spot and spotty infiltration of the pituitary . A bone marrow biopsy confirmed a diagnosis of cranial diabetes due to posterior pituitary MM infiltration.
多发性骨髓瘤（MM）可表现为中枢神经系统受累，形式为神经麻痹、浆细胞瘤，或罕见地因垂体受累而产生内分泌效应。通常，在这类病例中，疾病进展迅速且预后不良。我们报告一名52岁男性，2016年因长期低热和高钠血症入住印度加尔各答的加尔各答医学院。此后不久，患者开始抱怨尿频和嗜睡。高钠血症通过鼻内去氨加压素和补充游离水进行治疗。血清蛋白电泳和免疫固定研究显示存在免疫球蛋白G-κ单克隆条带。垂体磁共振成像显示垂体后叶亮点缺失及垂体斑点状浸润。骨髓活检确诊为因垂体后叶多发性骨髓瘤浸润导致的颅性尿崩症。
