Two Cases of Systemic Plasmacytosis Characterized by Low Levels of Lactic Dehydrogenase

TAKI Reiko, MATSUMURA Yumi, TANIOKA Miki, KORE-EDA Satoshi, ISHIKAWA Takayuki, MIYACHI Yoshiki

doi:10.11340/skinresearch.9.5_469

Two cases of systemic plasmacytosis are reported. Case 1: A man in his sixties consulted our hospital complaining of a two-year history of red-brown macules on his face and trunk. He had a swollen lymph node in the left groin. Skin and lymph node biopsy samples showed polyclonal plasma cell infiltration. The level of IgG was increased to 2,702mg/dl. He was followed without any treatment for the first two years but started on oral prednisolone 15mg/day two years after the initial examination. The patient had neither fever nor general fatigue during the course. The LDH levels have gradually decreased and the lowest level was 100IU/l. Case 2: A man in his fifties presented with a 4- to 5-year history of red-brown macules on his trunk, which had increased in size and number, and was accompanied by fever and general fatigue. Skin biopsy showed plasma cell infiltration in the dermis and the level of IgG was increased to 5,100mg/dl. Chest CT demonstrated ground-glass opacity in the right lung, which was compatible with lymphocytic interstitial pneumonia. He was started on oral prednisolone 15mg/day; fever and general fatigue disappeared but the skin eruptions did not respond to treatment. The lowest level of LDH was 102IU/l. According to previous reports, enzyme activity of LDH may be partly inhibited by overproduction of immunoglobulin via LDH-immunoglobulin complex. Therefore, LDH may be a marker that correlates with the disease activity of systemic plasmacytosis.

Two Cases of Systemic Plasmacytosis Characterized by Low Levels of Lactic Dehydrogenase

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