39例多发性骨髓瘤误诊分析

CLINICAL ANALYSIS OF 39 MISDIAGNOSED PATIENTS WITH MULTIPLE MYELOMA

１９８４年１１月～１９９４年６月收治４３例多发性骨髓瘤（ＭＭ），其中３９例曾误诊，误诊疾病多种。对其临床表现、误诊原因进行了分析。认为对４０岁以上有骨痛、贫血、高血钙症、肾功能不全、易感染、血清蛋白电泳见一异常球蛋白峰位于β－γ－球蛋白之间的区域、Ｘ线示多部位骨损害（如虫蚀样改变、骨质疏松、病理性骨折）者须高度警惕ＭＭ，进一步查骨髓浆细胞数增加及血尿中检出的蛋白可确诊。

patients with multiple myeloma(MM ) had been hospitalized from Nov,1984 to Jun,1994.Of whom misdiagnosis were found in 39 cases.They had been diagnosed as many other diseases, Features and the reasons of misdiagnosis were analyzed.MM should be suspected in patients aged more than 40 years old with bone pain ,anemia, hypercalcemia,renal insufficiency,susceptibility to infections,a tall sharp peak or localized band on serum protein electrophoresis and bone lesions such as punched-out lytic lesions,osteophorosis,or pathologic fractures etc. The diagnosis depends on the demonstrations of increased plasma cells in the bone marrow and appearance of monoclonal proteins in the serum or urine。