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目的提高对多发性骨髓瘤合并动静脉血栓形成的临床诊治水平。方法报道1例表现为反复胸腔积液,同时合并反复、多处静脉和动脉血栓形成患者的临床资料,并复习文献。结果该例62岁老年女性患者,合并右侧下肢静脉、肾动脉、脑动脉、颈动脉、肺动脉血栓反复形成,检查后明确诊断为多发性骨髓瘤IgGλ型、原发性淀粉样变,合并多处动静脉血栓形成,给予美法仑+泼尼松(MP)方案化疗和抗血小板、抗凝治疗后症状改善,随访13个月病情稳定,无新发血栓形成。结论多发性骨髓瘤可能合并动静脉血栓形成等不典型表现,需要进一步提高认识。
Objective To improve the clinical diagnosis and treatment of multiple myeloma with arteriovenous thrombosis. Methods One case of recurrent pleural effusion was reported. At the same time, clinical data of patients with recurrent and multiple venous and arterial thrombosis were retrospectively reviewed. Results The 62-year-old female patient with the right lower extremity venous, renal artery, cerebral artery, carotid artery and pulmonary thrombosis repeatedly formed. After diagnosis, it was clearly diagnosed as multiple myeloma IgGλ, primary amyloidosis, combined with multiple Department of arteriovenous thrombosis, given melphalan + prednisone (MP) regimen of chemotherapy and antiplatelet, anticoagulant therapy, symptoms improved, followed up for 13 months in stable condition, no new thrombosis. Conclusion Multiple myeloma may be associated with atypical manifestations such as arteriovenous thrombosis, which needs to be further improved.