[Waldenström巨球蛋白血症并发神经浸润引起的周围神经病变]。

Natsuki Norioka, Naoki Kurita, Yuya Kamura, Tatsuhiro Sakamoto, Takayasu Kato, Yasuhisa Yokoyama, Hidekazu Nishikii, Naoshi Obara, Mamiko Sakata-Yanagimoto, Hana Takahashi, Kiyotaka Nakamagoe, Akiko Ishii, Ryota Matsuoka, Toru Nanmoku, Akira Tamaoka, Shigeru Chiba
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引用次数: 0

摘要

51岁男性,主诉为手套型和长袜型感觉障碍>3年,基于igm型m蛋白血症、骨髓浆细胞样B细胞浸润、多发性淋巴结病变和脾肿大,诊断为Waldenström大球蛋白血症(WM)。神经传导检查提示脱髓鞘神经病。血清抗髓磷脂相关糖蛋白抗体阴性。腓肠神经活检显示髓鞘变薄,提示脱髓鞘。同时观察到束内神经外膜轴突损伤和肿瘤细胞浸润。经利妥昔单抗和苯达莫司汀化疗后,m蛋白血症和淋巴结病消失。然而,神经传导检查异常和感觉不良仅轻微减轻。由于描述WM伴周围神经浸润的文章有限,我们通过文献回顾来报道这一病例。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Waldenström macroglobulinemia complicated by peripheral neuropathy due to neural infiltration].

A 51-year-old man with the chief complaint of glove- and stocking-type dysesthesia for >3 years was diagnosed with Waldenström's macroglobulinemia (WM) based on IgM-type M-proteinemia, bone marrow infiltration of plasmacytoid B cells, multiple lymphadenopathies, and splenomegaly. A nerve conduction examination suggested demyelinating neuropathy. Serum anti-myelin-associated glycoprotein antibody was negative. Sural nerve biopsy showed myelin thinning, suggesting demyelination. Axonal damage and tumor cell infiltration in the intrafascicular epineurium were also observed. After chemotherapies with rituximab and bendamustine, M-proteinemia and lymphadenopathies disappeared. However, abnormalities in the nerve conduction examination and dysesthesia were only slightly alleviated. As articles describing patients with WM with peripheral nerve infiltration are limited, we report this case with a literature review.

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