Ohe Masashi, Hashino Satoshi, Shida Haruki, Horita Tetsuya, Sugiura Mitsuru
Department of Internal Medicine, JCHO Hokkaido Hospital, Sapporo, Japan.
Health Care Center, Hokkaido University, Sapporo, Japan.
Transl Clin Pharmacol. 2017 Sep;25(3):134-137. doi: 10.12793/tcp.2017.25.3.134. Epub 2017 Sep 15.
We report a case of Waldenström's macroglobulinemia (WM) treated using clarithromycin (CAM) and prednisolone (PSL). An 84-year-old woman was admitted to our hospital for bleeding after a tooth extraction and hematuria. Computed tomography showed multiple ill-defined nodules in the omentum (omental cake). Although the cause of the omental cake remained unclear, the patient was diagnosed with WM, based on the detection of M-protein of immunoglobulin (Ig) M in serum and lymphoplasmacytes in bone marrow. The bleeding tendency in the patient may have been due to acquired hemophilia and/or hyper IgM-induced platelet dysfunction. The patient was treated using CAM (800 mg/day) and PSL (10 mg/day). As a result, IgM levels gradually decreased. Because the omental cake contracted along with improvement in IgM, it was thought to be lymphoplasmacytic lymphoma-like lymphoma. This case shows that treatment using CAM and PSL may be effective in some cases of WM.
我们报告了一例使用克拉霉素（CAM）和泼尼松龙（PSL）治疗的华氏巨球蛋白血症（WM）病例。一名84岁女性因拔牙后出血和血尿入院。计算机断层扫描显示大网膜内有多个边界不清的结节（网膜饼）。尽管网膜饼的病因尚不清楚，但根据血清中免疫球蛋白（Ig）M的M蛋白和骨髓中的淋巴浆细胞检测，该患者被诊断为WM。患者的出血倾向可能是由于获得性血友病和/或高IgM诱导的血小板功能障碍。该患者接受了CAM（800毫克/天）和PSL（10毫克/天）治疗。结果，IgM水平逐渐下降。由于随着IgM的改善网膜饼缩小，因此认为是淋巴浆细胞样淋巴瘤。该病例表明，使用CAM和PSL治疗在某些WM病例中可能有效。
