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华氏巨球蛋白血症:一名老年男性的临床表现、诊断与管理

Waldenstrom Macroglobulinemia: Clinical Presentation, Diagnosis, and Management in an Elderly Male.

作者信息

Shahab Shahman, Semerdzhiev Dimitar I, Reeves James, Daniel Amy, Martin David E, Sukpraprut-Braaten Suporn

机构信息

Medicine, Arkansas College of Osteopathic Medicine, Fort Smith, USA.

Medicine, Unity Health, Searcy, USA.

出版信息

Cureus. 2023 Aug 25;15(8):e44127. doi: 10.7759/cureus.44127. eCollection 2023 Aug.

Abstract

Waldenstrom macroglobulinemia (WM) is a rare lymphoproliferative disease that can have an ambiguous clinical presentation. A key component of the pathophysiology of WM is bone marrow infiltration, which most commonly presents as anemia. Other symptoms of WM tend to be generalized and non-specific, which presents a diagnostic challenge. This was the case with our patient as well, when he presented to our outpatient clinic with non-specific symptoms. We present a 79-year-old male with longstanding pancytopenia, polyarthralgia, bilateral pedal edema, decreased appetite, and increased bleeding from wounds. The patient had a complete blood count (CBC) and complete metabolic panel (CMP) done, confirming present anemia, which prompted inpatient treatment and an oncology workup, confirming WM. The patient began a zanubrutinib monotherapy regimen, showing improvement in his pancytopenia, polyarthralgia, and overall symptoms.

摘要

华氏巨球蛋白血症(WM)是一种罕见的淋巴增殖性疾病,临床表现可能不明确。WM病理生理学的一个关键组成部分是骨髓浸润,最常见的表现为贫血。WM的其他症状往往较为普遍且不具特异性,这给诊断带来了挑战。我们的患者也是如此,他因非特异性症状前来我们的门诊就诊。我们报告一例79岁男性患者,有长期全血细胞减少、多关节痛、双侧足背水肿、食欲减退以及伤口出血增多的症状。患者进行了全血细胞计数(CBC)和全代谢组检查(CMP),证实存在贫血,这促使其接受住院治疗并进行肿瘤学检查,最终确诊为WM。患者开始使用泽布替尼单药治疗方案,其全血细胞减少、多关节痛及总体症状均有所改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/336c/10518236/e45d3e3ae249/cureus-0015-00000044127-i01.jpg

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