Rostoker G, Uzzan B, Baumelou E, Chapman A
Nouv Rev Fr Hematol (1978). 1986;28(1):27-32.
The case of a multiple myeloma secreting IgG kappa in both mother and daughter is reported and discussed in the light of previous reports of familial myeloma and myeloma occurring in spouses. In March 1981, the 60-year-old daughter complained of fatigue leading to the discovery of anemia. The diagnosis of myeloma was based on the association of a monoclonal IgG kappa (57.5 g/l) with low serum levels of IgM and IgA and of an increase (38%) in bone marrow plasma cells. She was treated by chemotherapy and by radiotherapy on bone lesions which appeared during the course of treatment. She died in June 1983. In October 1984, the 84-year-old mother was also found to have anemia. The diagnosis of myeloma was based on the association of a monoclonal IgG kappa (24.5 g/l) with low serum levels of IgM and IgA, 0.6 g/l of Bence-Jones protein in urine, an increase (12%) of atypical plasma cells, and of multiple lytic lesions on X-ray. Familial myeloma has been exceptionally reported. We have found only one case in mother and daughter where the myeloma protein was respectively IgA and IgG. The light chain isotype was not determined. Cases of myeloma occurring in spouses have equally been rarely reported in the medical literature. Genetic transmission of chromosomal determinants for myeloma or a type of response to environmental factors have been suspected as well as environmental determinants for myeloma. Genetically abnormal regulation of immunoglobulin synthesis is another possibility.
本文报告了一例母女均分泌IgG κ型多发性骨髓瘤的病例，并结合既往家族性骨髓瘤及配偶间发生骨髓瘤的报道进行了讨论。1981年3月，60岁的女儿因疲劳就诊，发现贫血。骨髓瘤的诊断依据为单克隆IgG κ（57.5 g/l）、血清IgM和IgA水平降低以及骨髓浆细胞增多（38%）。她接受了化疗及针对治疗过程中出现的骨病变的放疗。1983年6月去世。1984年10月，84岁的母亲也被发现患有贫血。骨髓瘤的诊断依据为单克隆IgG κ（24.5 g/l）、血清IgM和IgA水平降低、尿中本-周蛋白0.6 g/l、非典型浆细胞增多（12%）以及X线显示多发溶骨性病变。家族性骨髓瘤的报道极为罕见。我们仅发现一例母女患骨髓瘤的病例，其中骨髓瘤蛋白分别为IgA和IgG，轻链亚型未确定。医学文献中配偶间发生骨髓瘤的病例同样少见。骨髓瘤染色体决定因素的遗传传递、对环境因素的某种反应类型以及骨髓瘤的环境决定因素均受到怀疑，免疫球蛋白合成的基因异常调控也是一种可能。
