Kanemoto Hideka, Obata Kyoichi, Kadoya Koichi, Ono Kisho, Kawai Hotaka, Kunisada Yuki, Yao Mayumi, Ibaragi Soichiro
Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata, Okayama 700-8525, Japan.
Department of Oral and Maxillofacial Surgery, Kochi Health Sciences Center, 2125-1 Ike, Kochi 781-8555, Japan.
Case Rep Dent. 2024 Oct 28;2024:8836103. doi: 10.1155/2024/8836103. eCollection 2024.
Amyloidosis is a disease in which amyloid protein is deposited in organs and tissues, resulting in functional impairment. Amyloidosis occurs in 12%-30% of patients with multiple myeloma, but in rare cases, amyloidosis may precede the diagnosis of multiple myeloma. Our patient was a 76-year-old Japanese male on dialysis. Multiple nodules accompanied by ulcers were observed on his tongue. He had no subjective symptoms or clinical findings associated with multiple myeloma. The histopathological findings suggested amyloidosis. We suspected both systemic and localized amyloidosis and performed a comprehensive systemic examination. Since the patient had been on dialysis for only a short period of time (~3 months), dialysis-related amyloidosis was ruled out. After blood and urine tests, a diagnosis of multiple myeloma was made. Chemotherapy treatment was started, but the patient's multiple myeloma could not be suppressed and the tongue amyloidosis worsened, leading to his death 2 years and 2 months after the initial diagnosis.
淀粉样变性是一种淀粉样蛋白沉积于器官和组织中，导致功能障碍的疾病。淀粉样变性发生于12% - 30%的多发性骨髓瘤患者中，但在罕见情况下，淀粉样变性可能先于多发性骨髓瘤的诊断出现。我们的患者是一名76岁接受透析治疗的日本男性。在他的舌头上观察到多个伴有溃疡的结节。他没有与多发性骨髓瘤相关的主观症状或临床发现。组织病理学检查结果提示为淀粉样变性。我们怀疑是全身性和局限性淀粉样变性，并进行了全面的系统检查。由于患者仅接受了短时间（约3个月）的透析治疗，排除了透析相关的淀粉样变性。经过血液和尿液检查，诊断为多发性骨髓瘤。开始进行化疗，但患者的多发性骨髓瘤无法得到控制，舌部淀粉样变性恶化，在初次诊断后2年2个月死亡。
