Louisiana State University Health Sciences Center New Orleans, USA.
J Investig Med High Impact Case Rep. 2022 Jan-Dec;10:23247096211052187. doi: 10.1177/23247096211052187.
A patient was diagnosed with Waldenström's macroglobulinemia (WM) after the initial findings of anemia and ophthalmological findings of retinal hemorrhage. Upon further workup, the patient was found to have an IgM predominant monoclonal gammopathy on serum protein electrophoresis (SPEP) and urine protein electrophoresis (UPEP). This highlights the need for open communication between different specialties, streamlining rapid and accurate diagnosis. Also highlighted are the unique pathophysiological changes involved in the development of WM. A patient's primary complaint was blurry vision. After the patient was noted to have a monoclonal gammopathy on SPEP, bone marrow biopsy was performed. The bone marrow biopsy findings were consistent with lymphoplasmacytic lymphoma (LPL). The patient received plasmapheresis and chemotherapy. The disease course is described. The patient saw rapid improvement in all lab abnormalities after the beginning of the appropriate therapy of plasmapheresis and chemotherapy. Remission is common with WM. Regular follow-up with this patient is important.
患者最初的检查结果为贫血和视网膜出血，后被诊断为瓦尔登斯特伦巨球蛋白血症（WM）。进一步检查发现，患者的血清蛋白电泳（SPEP）和尿蛋白电泳（UPEP）显示 IgM 为主的单克隆丙种球蛋白血症。这突出了不同专业之间进行开放沟通的必要性，以便快速准确地诊断。还强调了 WM 发展过程中涉及的独特病理生理变化。患者的主要主诉是视力模糊。在 SPEP 上发现患者有单克隆丙种球蛋白血症后，进行了骨髓活检。骨髓活检结果与淋巴浆细胞淋巴瘤（LPL）相符。患者接受了血浆置换和化疗。描述了疾病过程。患者在开始进行适当的血浆置换和化疗治疗后，所有实验室异常迅速改善。WM 常见缓解。对该患者进行定期随访很重要。
