Belkhribchia Mohamed Reda, Moukhlis Sara, Bentaoune Tarik, Chourkani Najat, Zaidani Mohamed, Karkouri Mehdi
Department of Neurology, Hassan II Regional Hospital, Dakhla, Morocco.
Pathologic Anatomy and Cytology Laboratory, University Hospital Center Ibn Rochd, Casablanca, Morocco.
Eur J Case Rep Intern Med. 2020 Nov 20;7(12):002095. doi: 10.12890/2020_002095. eCollection 2020.
Monoclonal gammopathies due to plasma cell dyscrasias can cause various rare neuromuscular disorders. The peripheral nervous system is most commonly affected, while muscle diseases associated with monoclonal gammopathies are rare. Skeletal myopathy, as a manifestation in the context of multiple myeloma, is extremely uncommon and is usually the result of immunoglobulin light chain (AL) amyloidosis deposits in the muscles. Here we present an atypical case of a patient with generalized myopathy as the presenting manifestation of light chain multiple myeloma. Interestingly, muscle involvement in our case was not the consequence of AL amyloidosis deposits but rather due to non-amyloid light chain deposition disease associated with light chain multiple myeloma.
Light chain multiple myeloma can present as myopathy.Creatine kinase and muscle biopsy specimens only examined using routine stains can be normal in this condition.
浆细胞发育异常导致的单克隆丙种球蛋白病可引起各种罕见的神经肌肉疾病。外周神经系统最常受累,而与单克隆丙种球蛋白病相关的肌肉疾病则较为罕见。骨骼肌病作为多发性骨髓瘤的一种表现极为罕见,通常是免疫球蛋白轻链(AL)淀粉样变性沉积于肌肉的结果。本文报告一例以全身肌病为首发表现的轻链型多发性骨髓瘤非典型病例。有趣的是,本例患者的肌肉受累并非AL淀粉样变性沉积所致,而是与轻链型多发性骨髓瘤相关的非淀粉样轻链沉积病所致。
轻链型多发性骨髓瘤可表现为肌病。在此情况下,仅使用常规染色检查的肌酸激酶和肌肉活检标本可能正常。