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1例多发性骨髓瘤误诊为血清阴性类风湿关节炎并文献复习

A Case of Multiple Myeloma Misdiagnosed as Seronegative Rheumatoid Arthritis and Review of Relevant Literature.

作者信息

Schoninger Scott, Homsi Yamen, Kreps Alexandra, Milojkvovic Natasa

机构信息

College of Medicine, SUNY Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY 11203, USA.

Division of Rheumatology, SUNY Downstate Medical Center, 450 Clarkson Avenue Box 42, Brooklyn, NY 11203, USA.

出版信息

Case Rep Rheumatol. 2018 Oct 11;2018:9746241. doi: 10.1155/2018/9746241. eCollection 2018.

Abstract

Multiple myeloma (MM) is a malignant plasma cell proliferation producing large numbers of monoclonal immunoglobulins. Typical MM symptoms include anemia, renal failure, hypercalcemia, and bone pain. Atypical symptoms have rarely been reported in the literature. We report a case of a 58-year-old male who presented with symmetrical inflammatory polyarthritis and was misdiagnosed with seronegative rheumatoid arthritis (RA). After failing many RA treatments and with further workup, the diagnosis of MM was made. This rare manifestation of MM carries a diagnostic challenge and causes a significant delay in treating such patients. Here, we report this unusual initial presentation with review of several cases in the English literature describing similar presentations.

摘要

多发性骨髓瘤(MM)是一种恶性浆细胞增殖性疾病,可产生大量单克隆免疫球蛋白。典型的MM症状包括贫血、肾衰竭、高钙血症和骨痛。非典型症状在文献中鲜有报道。我们报告一例58岁男性患者,其表现为对称性炎性多关节炎,最初被误诊为血清阴性类风湿关节炎(RA)。在多种RA治疗均无效并进一步检查后,确诊为MM。MM的这种罕见表现带来了诊断挑战,并导致此类患者的治疗显著延迟。在此,我们报告这一不寻常的首发表现,并回顾英文文献中几例描述类似表现的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db1c/6201338/65ba99477f2c/CRIRH2018-9746241.001.jpg

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