以吞咽困难为首发症状的AL型舌淀粉样变合并多发性骨髓瘤1例报告

A case report of AL amyloidosis complicated with multiple myeloma with dysphagia as the first symptom

系统性轻链型(AL)淀粉样变性(amyloidosis)合并多发性骨髓瘤(multiple myeloma,MM)是一种临床上罕见的浆细胞相关恶性疾病。大多数患者因心脏、肾脏功能损伤或实质性骨髓瘤为主诉就诊,以吞咽困难或其他口腔相关疾病为首发症状的病例罕见,故初诊时易漏诊误诊。本文报告1例以吞咽困难为首发症状的淀粉样变性合并多发性骨髓瘤病例,结合相关文献,对该病的特点、诊断标准及治疗方法进行讨论。

Systemic light-chain-type amyloidosis combined with multiple myeloma(MM) is a clinically rare plasma cellassociated malignant disease.Most of the patients with this disease are complained for heart/renal impairment or substan-tial myeloma,and very few cases presented dysphagia or other oral related diseases as the first symptom,so it is easy to miss diagnosis or make misdiagnosis during first visit.Therefore,the diagnosis and treatment of amyloidosis with dysphagia was reported in the article.Based on the relevant literature review,the characteristics,diagnostic criteria and treatment of the disease were discussed.