多发性骨髓瘤误诊急性胰腺炎1例

Multiple myeloma misdiagnosed as acute pancreatitis: A cases report

多发性骨髓瘤(multiple myeloma,MM)是恶性浆细胞病中最常见的一种类型,又称骨髓瘤、浆细胞骨髓瘤或Kahler病.近年来发病率逐年增加,因为早期临床症状体征不典型,且可累及全身多组织器官,极易漏诊和误诊.本文报道1例患者,以血、尿淀粉酶明显升高为突出表现,骨髓涂片及活检结果均示浆细胞增生,血清和尿出现单克隆M蛋白,同时伴有骨痛、肾功能损害、贫血、颅骨骨质破坏,确诊为MM.临床医生应提高对类似病例的认识,及时行相关检查,避免误诊.

As the most common form of malignant plasma cell disease, multiple myeloma is also known as myeloma, plasma cell myeloma or Kahler＇ s disease. The incidence of multiple myeloma has gradually increased in recent years, but the diagnosis is often difficult due to various clini- cal manifestations and multiple affected organs. In this article, we report a case of multiple my- eloma in a patient with abnormal accumulation of plasma cells in bone marrow, elevated level of a monoclonal protein in serum and urine, bone pain, renal injury, anemia, skull fractures and, intriguingly, high level of amylase in blood and urine. Although it was initially misdiagnosed as acute pancreatitis, the patient is finally diag- nosed with multiple myeloma. Clinicians will benefit from this case in terms of how to im- prove diagnosis rate and avoid misdiagnosis.