Mitchell M A, Horneffer M D, Standiford T J
Department of Internal Medicine, University of Michigan Medical School, Ann Arbor 48199-0360.
Chest. 1993 Mar;103(3):946-7. doi: 10.1378/chest.103.3.946.
Restrictive cardiomyopathy from amyloid deposition within the myocardium is a well-described complication of multiple myeloma; however, myelomatous involvement of pericardium with subsequent cardiac tamponade has rarely been described. Optimal treatment for malignant involvement of the pericardium by myeloma cells has yet to be established. The following description is of a patient with myocardial and pericardial manifestations of multiple myeloma. Treatment of the malignant pericardial effusion was implemented with intrapericardial administration of bleomycin. This therapy resulted in no recurrence of pericardial effusion at nine days follow-up. Despite the absence of detectable recurrent effusion, the patient died suddenly from causes felt unrelated to pericardial disease.
心肌内淀粉样蛋白沉积导致的限制性心肌病是多发性骨髓瘤一种广为人知的并发症；然而，骨髓瘤累及心包并随后导致心脏压塞的情况却鲜有报道。骨髓瘤细胞恶性累及心包的最佳治疗方法尚未确定。以下描述的是一名患有多发性骨髓瘤心肌和心包表现的患者。采用心包内注射博来霉素治疗恶性心包积液。该治疗在9天的随访中未出现心包积液复发。尽管未检测到复发性积液，但患者突然死亡，死因被认为与心包疾病无关。
