Cryoglobulin crystal arthropathy in a patient with multiple myeloma.
Cryoglobulin crystal arthropathy in a patient with multiple myeloma.
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多发性骨髓瘤患者的冷球蛋白晶体关节病。
DOI：
10.1097/rhu.0b013e3181a567b5
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
L. Brent
中科院分区：
文献类型：
--
作者：
Alejandra C Rodriguez;Mythili Seetharaman;L. Brent
在单克隆性伽马病患者中，关节受累是不常见的。它被典型地描述为类风湿样血清阴性的多关节侵袭性关节病，也与滑膜和其他几种组织中冷球蛋白的结晶沉积有关。本报告描述一位57岁的非洲裔美国女性，患有血清阴性的多发性关节炎，并伴有滑液中无双折射或弱正双折射的菱形晶体沉积。这名患者后来被诊断为多发性骨髓瘤，对口服和关节内皮质类固醇表现出良好的临床反应。在血清和滑液中都发现了II型冷球蛋白。将这种联系作为多发性骨髓瘤和关节炎患者鉴别诊断的一部分是很重要的。
Joint involvement is unusual in patients with monoclonal gammopathies. It has been characteristically described as a rheumatoid-like seronegative polyarticular erosive arthropathy, which also has been related to crystal deposition of cryoglobulins in the synovium and several other tissues. This report describes the case of a 57-year-old African American woman with a seronegative polyarthritis associated with deposition of nonbirefringent or weakly positive birefringent rhomboid-shaped crystals in the synovial fluid. The patient, who was subsequently diagnosed with multiple myeloma, showed good clinical response to oral and intra-articular corticosteroids. Type II cryoglobulins were identified in the serum as well as in the synovial fluid. It is important to consider this association as part of the differential diagnosis of a patient with multiple myeloma and arthritis.