Di Tullio Fernando, Ernst Glenda, Vigovich Félix, Shanley Claudia, Chertcoff Felipe, Bosio Martín
Centro de Medicina Respiratoria, Hospital Británico de Buenos Aires, Argentina. E-mail:
Centro de Medicina Respiratoria, Hospital Británico de Buenos Aires, Argentina.
Medicina (B Aires). 2018;78(6):443-446.
Multiple myeloma is a hematologic disease, which accounts for 15% of hematologic malignancies. The average age of onset is between 65-70 years and is very rare in young patients, as 2% are under 40 years old. We present a case of 36-year-old women with history of 20 pack years (p/y) smoking, who complaints of dyspnea associated with signs of right cardiac overload, anemia, proteinuria, elevated acute phase reactants and spirometry pattern suggestive of moderately-severe restriction and severe drop in diffusing capacity for carbon monoxide (DLCO). Echocardiogram evidence dilated right heart cavities and signs of pulmonary hypertension which is confirmed by right heart catheterization. In search of the etiology we arrive to the diagnosis of multiple myeloma.
多发性骨髓瘤是一种血液系统疾病，占血液系统恶性肿瘤的15%。其平均发病年龄在65至70岁之间，在年轻患者中非常罕见，2%的患者年龄在40岁以下。我们报告一例36岁女性病例，该患者有20包年吸烟史，主诉呼吸困难，并伴有右心负荷过重、贫血、蛋白尿、急性期反应物升高以及肺功能检查显示中度至重度受限和一氧化碳弥散量（DLCO）严重下降的体征。超声心动图显示右心腔扩张及肺动脉高压体征，右心导管检查证实了这一点。在寻找病因的过程中，我们诊断为多发性骨髓瘤。
