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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。
In the case of osteoporosis, multiple myeloma (MM), the main clinical manifestation of fracture, is easily missed. Now report a 72-year-old man, because of nephrotic syndrome after long-term use of glucocorticoid serious osteoporosis, but the regular anti-osteoporosis recurring vertebral fractures. Combined with previous immunoelectrophoresis showed that IgGκ monoclonal antibody (M protein), bone marrow puncture see clonal plasma cells, consider the concurrent MM. This article also reviews osteoporosis and MM related literature.