系统性红斑狼疮合并多发性骨髓瘤的临床特点分析

Clinical characteristics of systemic lupus erythematosus associated with multiple myeloma

目的系统性红斑狼疮(SLE)合并多发性骨髓瘤(MM)临床上十分少见。本文旨在通过分析SLE合并MM患者的临床特点和诊治经验,以推断SLE和MM二者间的联系。方法本文报道了1例68岁女性同时被诊断为SLE和MM。通过检索PubMed近35年来国外发表的SLE合并MM的病例共15例,列表和归纳其临床特点。结果文献报道的15例患者中女性明显多于男性(男∶女=1∶14),诊断为MM时中位年龄49岁,明显早于一般人群中MM的诊断年龄。其SLE的症状以关节炎/关节痛、红斑/光敏性皮疹和血液系统损害的发生率较高,分别占80.0%、60.0%和66.7%,与单纯SLE患者的症状发生率无明显差异。有1/3的患者诊断为MM时其SLE稳定或血清学检查阴性。有12例患者血液中检出M蛋白。结论 SLE患者中可能出现意义未明的单克隆免疫球蛋白病,可能使进展为MM的风险增加。

Objective To investigate the association between systemic lupus erythematosus （SLE） and multi-ple myeloma （MM） .Methods Clinical data of one 68-year-old woman with diagnosis of SLE combined with MM was analyzed .Clinical characteristics of SLE combined with MM were analyzed in 15 cases ,reported in articles of recent 35 years ,retrieved from PubMed database .Results In these 15 cases ,the proportion of female was higher than male （male∶female=1∶14） .The median age at diagnosis of MM was 49 ,which was obviously earlier than the age at di-agnosis of MM in general population .The incidence rates of main symptoms of SLE in patens combined with SLE and MM,including arthritis/arthralgia ,erythema/light sensitivity rashes and blood system damage ,were 80 .0% ,60 .0%and 66 .7% ,which were not different with patients single with SLE .Five cases were at stable stage of SLE or with negative serological changes ,when they were diagnosed with MM.Mprotein could be detected in 12 cases . Conclusion Monoclonal gammopathy of undetermined significance could be exist in SLE patients ,which might in-crease the onset risk of MM.