単クローン性IgG血症を伴った骨髄線維症の1例

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書誌事項

タイトル別名
  • A Case of Myelofibrosis with IgG (κ) Monoclonal Gammopathy
  • タン クローンセイ IgG ケッショウ オ トモナッタ コツズイ センイショウ

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抄録

A 73-year-old female was admitted on September 1980 because of lumbar and upper back pain. Physical examinations revealed severe anemia and hepatosplenomegaly. Peripheral Blood: Hb 7.6 g/dl, RBC 277×104/cmm, Ht 23.4%, reticulocyte 22‰, WBC 5,000/cmm with leukoerythroblastosis, rouleaux formation and tear drop cells, platelet 12.2×104/cmm. Bone marrow aspirations performed twice were dry tap. Biochemical analysis of the blood: total protein 9.0 g/dl with M-spike (24.5%) in the beta globulin region. Serum IgG level was 4,640 mg/dl, IgA 86 mg/dl and IgM 90 mg/dl. Immunoelectrophoresis of the serum revealed IgG (κ) type paraprotein. On bone survey, considerable generalized osteoporosis with compression fructures of Th11 and Th12 were demonstrated. Although a definite diagnosis of multiple myeloma was not made, clinical and laboratory features suggested that a diagnosis of premyeloma might be made. Biopsied specimens from the bilateral iliac crest showed myelofibrosis without marked increase in the plasma cells. Ferrokinetics: PID T1/2 47 min.; radioactivity was high over the spleen with sharp decline and low over the livr and bone marrow.<br>Therefore, this patient probably had premyeloma associated with myelofibrosis.<br>The possible relationship between the two disorders is discussed.

収録刊行物

  • 臨床血液

    臨床血液 23 (5), 783-791, 1982

    一般社団法人 日本血液学会

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