Ig A·K型骨髓瘤伴严重拔牙后出血

Masahiro Urade , Masakazu Sugi, Keiji Nishimura, Masaru Sugiyama, Noboru Yakushiji, Tadashi Miyazaki
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引用次数: 4

摘要

一例多发性骨髓瘤检测的第一症状是严重的拔牙后出血提出。虽然实验室数据显示严重贫血、红细胞rouleaux形成、止血参数异常、红细胞沉降率升高和高球蛋白血症,但x线检查未显示颌骨、颅骨、肋骨或胸骨等骨骼受累。免疫电泳最终诊断为Ig A·K型骨髓瘤。在美法兰和普雷多宁治疗期间,反复出现创口出血。首次出现症状2个月后,患者死于全身性出血。尸检结果显示肺、胃、肾和膀胱有许多出血部位,腰椎和胸骨骨髓中存在浆细胞样肿瘤细胞。
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Ig A · K type myeloma with severe postextraction bleeding

A case of multiple myeloma detected by the first symptom of severe postextraction bleeding was presented. Although laboratory data showed severe anemia, rouleaux formation of erythrocytes, abnormal hemostatic parameters, elevated erythrocyte sedimentation rate and hyper-globulinemia, no involvement of bones such as the jaws, skull, ribs or sternum was demonstrated roentgenologically. Final diagnosis obtained by Immunoelectrophoresis was Ig A · K type myeloma. During a therapeutic period with melphalan and predonine, bleeding from the extracted wound was repeated. 2 months after the onset of the first symptoms, the patient died of systemic bleeding. Autopsy findings revealed many hemorrhagic sites in the lungs, stomach, kidney and bladder and the existence of plasma cell-like tumor cells in the bone marrow of lumber vertebra and sternum.

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