Monoclonal gammopathy of undetermined significance (MGUS) characterized by refractory lower gastrointestinal postoperative bleeding with coagulopathy

DOI Web Site 参考文献17件
  • Zhang Shuxia
    Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital, Fuzhou, China.
  • Chen Zhifen
    Colorectal Surgery Department, Fujian Medical University Union Hospital, Fuzhou, China.
  • Huang Meijuan
    Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital, Fuzhou, China.
  • Zhan Rong
    Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital, Fuzhou, China.
  • Wu Long
    Department of Pathology, Fujian Medical University Union Hospital, Fuzhou, China.
  • Zhang Qian
    Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital, Fuzhou, China.
  • Lin Yu
    Colorectal Surgery Department, Fujian Medical University Union Hospital, Fuzhou, China.
  • Jiang Weizhong
    Colorectal Surgery Department, Fujian Medical University Union Hospital, Fuzhou, China.
  • Chi Pan
    Colorectal Surgery Department, Fujian Medical University Union Hospital, Fuzhou, China.
  • Yang Feng'e
    Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital, Fuzhou, China.

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<p>Bleeding is a common complication after lower gastrointestinal surgery, and cases due to coagulation dysfunction are rare. The current authors encountered a 54-year-old Chinese man with refractory bleeding after endoscopic rectal polypectomy, and multiple endoscopic and surgical interventions failed to control that bleeding. An APTT mixing test could not be corrected and there was no evidence of autoimmune-related disease, so the presence of nonspecific antibodies was considered. After empiric therapy with a cyclophosphamide and glucocorticoid, APTT was corrected and gastrointestinal bleeding stopped. Based on laboratory results and therapeutic results, the patient was ultimately diagnosed with prolonged APTT induced by monoclonal gammopathy of undetermined significance (MGUS). MGUS and coagulopathy characterized by a prolonged APTT has rarely been reported. Here, studies noting elevated monoclonal immunoglobulins and coagulopathy have been reviewed. If a prolonged APTT of undetermined significance cannot be corrected with an APTT mixing test and if autoimmune-related factors are excluded, then plasma cell-related diseases such as MGUS need to be considered. </p>

収録刊行物

  • Intractable & Rare Diseases Research

    Intractable & Rare Diseases Research 11 (4), 206-210, 2022-11-30

    特定非営利活動法人 バイオ＆ソーシャル・サイエンス推進国際研究交流会

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