Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
Department of Neurology, James Paget University Hospital NHS Foundation Trust, Great Yarmouth, UK.
BMJ Case Rep. 2021 Feb 23;14(2):e240242. doi: 10.1136/bcr-2020-240242.
A previously fit and well 76-year-old man, presented with distal lower limb sensory symptoms suggestive of peripheral sensory neuropathy, associated with positive anti-MAG antibodies (myelin associated glycoprotein) and IgM paraprotein. Bone marrow biopsy showed lymphoplasmocytoid lymphoma (Waldenstrom's macroglobulinaemia, WM), consequently positive for MYD88 mutation. He subsequently developed medullary carcinoma of the thyroid, most likely secondary to WM. He underwent a successful total thyroidectomy and four treatment doses of rituximab, which proved beneficial. He is currently stable and under multidisciplinary monitoring. His sensory symptoms have improved following rituximab treatment and his WM is under control.
一位先前身体健康的 76 岁男性，出现下肢远端感觉症状，提示周围感觉神经病，伴有抗 MAG 抗体（髓鞘相关糖蛋白）和 IgM 副蛋白阳性。骨髓活检显示淋巴浆细胞淋巴瘤（华氏巨球蛋白血症，WM），因此 MYD88 突变阳性。随后他发展为甲状腺髓样癌，很可能继发于 WM。他成功接受了全甲状腺切除术和四剂利妥昔单抗治疗，这被证明是有益的。他目前病情稳定，正在接受多学科监测。他的感觉症状在利妥昔单抗治疗后有所改善，WM 得到了控制。
