双下肢水肿-反复骨折-M蛋白

Lower extremities edema-Repeated fractures-M protein

在并发骨质疏松症的情况下,以骨折为主要临床表现的多发性骨髓瘤(mulitiple myoloma,MM)容易被漏诊。现报告1例72岁男性,因肾病综合征长期使用糖皮质激素后出现严重骨质疏松症,但规律抗骨质疏松过程中反复发生椎体骨折。结合既往多次免疫固定电泳提示IgGκ型单克隆球蛋白(monoclonal protein,M蛋白),骨髓穿刺见克隆性浆细胞,考虑并发MM。本文同时对骨质疏松症及MM的相关文献进行复习。

When coexisted with osteoporosis, mutiple myeloma （ MM ） with the main symptom of fracture was easy to be misdiagnosed. Here we reported a 72-year-old male with severe osteoporosis induced by long term treatment of glucocortieoid hormone, ＂after he was diagnosed as nephrotic syndrome. However, repeated vertebral fractures occurred on regular antl-osteoporotic treatment. M protein of IgGK was detected previously by immunof/xation electrophoresis for several times, and clonal plasma cells were found in bone malTow, which supported the diagnosis of MM. The literature about osteoporosis and MM was reviewed.