[Coma, hyperviscosity syndrome, hyperammonemia and myelofibrosis in a patient with IgG, lambda type multiple myeloma].
[Coma, hyperviscosity syndrome, hyperammonemia and myelofibrosis in a patient with IgG, lambda type multiple myeloma].
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[IgG、lambda 型多发性骨髓瘤患者的昏迷、高粘滞综合征、高氨血症和骨髓纤维化]。
DOI：
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发表时间：
1989
期刊：
影响因子：
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通讯作者：
Y. Miura
中科院分区：
文献类型：
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作者：
S. Tsunoda;R. Sasaki;A. Miwa;I. Sakurabayashi;Y. Miura
一名 63 岁男性因颤抖和嗜睡入院，随后很快昏迷。观察到贫血和视网膜出血。血涂片显示有轮状形成和白红细胞增多症。骨髓抽吸导致干抽。活检标本显示骨髓瘤细胞明显浸润并伴有纤维化。血清中检测到IgG-lambda型M成分和高氨血症。但肝肾功能均在正常范围内。血浆置换后，他的意识恢复了。两个疗程的VMCP（长春新碱、美法仑、卡波醌和泼尼松龙）对副蛋白血症没有影响。五个疗程的VAD（长春新碱、阿霉素和地塞米松）可以降低IgG水平。他死于肺炎。一些多发性骨髓瘤患者的血浆可能含有导致血浆氨升高的不明因素。
A 63-year-old man was admitted to our hospital with tremor and somnolence, followed soon by coma. Anemia and retinal bleeding were observed. The blood smear exhibited rouleaux formation and leukoerythroblastosis. A bone marrow aspiration resulted in dry tap. The biopsy specimens revealed remarkable infiltration of myeloma cells with fibrosis. The M-component of IgG-lambda type and hyper-ammonemia were detected in the serum. Liver and renal functions, however, were within normal range. His consciousness recovered after plasmapheresis. Two courses of VMCP (vincristine, melphalan, carboquone and prednisolone) did not affect the paraproteinemia. Five courses of VAD (vincristine, adriamycin and dexamethasone) could lower the level of IgG. He died of pneumonia. The plasma of some patients with multiple myeloma may contain unidentified factors which increase the plasma ammonia.