多发性骨髓瘤与出血性透析中的三克隆性肉膜病变:一个病例报告
H R Samruddhi1, Rukmini Mysore Srikantiah1, Sindhu Harish1
1Department of Biochemistry, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India.
这项研究报告了一例极为罕见的三克隆性胃病变病例,该病例发生在患有贫血和出血症状的患者身上. 涉及IgM Kappa,IgG Kappa和IgA Lambda的三角性甘马病,在血细胞失分症中异常罕见.
科学领域:
- 血液学 血液学 血液学
- 免疫学 免疫学 免疫学
背景情况:
- 在诊断淋巴增殖性疾病和血细胞失分症方面,淋巴病具有重要意义.
- 多发性骨髓瘤涉及恶性血细胞生长,产生单克隆性免疫球蛋白.
- 一名70岁的患者出现了表,直肠出血和严重的贫血,在血液测试中显示了全细胞减小.
研究的目的:
- 为了调查一种罕见的三克隆性胃病变病例.
- 为了表征这种罕见的情况中的血细胞的免疫表型.
主要方法:
- 血液图,生物化学测试,血清蛋白电泳 (SPE),无血清轻链检测.
- 进行了免疫固定电泳,骨髓吸收细胞学,免疫型和流细胞计.
主要成果:
- 免疫固定揭示了三克隆性胃病变:IgM 卡帕,IgG 卡帕和IgA 兰巴.
- SPE显示M波段为5.6gm%,卡帕/兰巴达比率高达18.18.
- 骨髓分析显示,大约有4-4.7%的异常血细胞具有特定的免疫表型标记 (CD38/CD138明亮,CD81+,CD27+,CD45暗,CD56变量).
结论:
- 在血细胞失分症中,单克隆性甘美病是常见的;双克隆性较少发生.
- 三角性胃病变,特别是IgM Kappa,IgG Kappa和IgA Lambda,是非常罕见的.
- 这种特定的三克隆性胃病组合的临床意义仍需确定.
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