Vaiopoulos G, Kyriakou D, Papadaki H, Fessas P, Eliopoulos G D
First Department of Internal Medicine of the University of Athens School of Medicine, Laiko General Hospital, Greece.
Haematologica. 1994 May-Jun;79(3):262-4.
A rare case of multiple myeloma associated with severe Coombs-positive hemolytic anemia is described. A 60-year-old woman was hospitalized for acute hemolysis due to an IgG warm autoantibody with pan-agglutinin specificity. Serum and urine electrophoresis revealed the presence of a monoclonal IgGk protein and a BJk protein, respectively. Bone marrow aspirates showed diffuse infiltration with plasma cells, and skeletal survey revealed lytic lesions in the skull and diffuse osteoporosis. Treatment with prednisone, and subsequently with melphalan, cyclophosphamide and vincristine resulted in hematological improvement within two weeks. A reduction of paraprotein below 50% of the initial levels was found after six months of therapy.
本文描述了一例罕见的多发性骨髓瘤合并严重的库姆斯阳性溶血性贫血病例。一名60岁女性因具有全凝集素特异性的IgG温抗体导致急性溶血而住院。血清和尿液电泳分别显示存在单克隆IgGk蛋白和BJK蛋白。骨髓穿刺显示浆细胞弥漫性浸润，骨骼检查发现颅骨有溶骨性病变和弥漫性骨质疏松。使用泼尼松治疗，随后使用美法仑、环磷酰胺和长春新碱治疗，两周内血液学状况得到改善。治疗六个月后，副蛋白水平降至初始水平的50%以下。
