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多发性骨髓瘤肾病系指瘤细胞浸润及其产生的大量异常免疫球蛋白从尿中排出而引起的肾脏病变,症状以蛋白尿为主,易误诊。将我院1985年～1992年收治的7例病人报导如下: 1 临床资料 男4例,女3例。年龄38～67岁。均有蛋白尿及贫血,下肢浮肿、骨痛2例,高血压4例,发热3例,反复肺部感染2例,肝脾肿大2例。尿蛋白总量4.2～17g/24h,镜下血尿2例,管型尿4例。尿本周氏蛋白均为阴性。尿免疫电泳IgG4例、IgA3例。HLO 31～64L,白细胞及血小板减少1例。血沉58～113mm/h。肾功能正常及重度损害各2例,中度损害3例,血尿酸升高5例。转氨酶均正常,r球蛋白、球蛋白均增高,A/G均倒置,5例出现M带,HBsAg阳性2例。免疫球蛋白IgG升高4例、IgA升高3例。B超检查肝脾肿大2例。颅骨及/或骨盆呈散在洞齿样改变5例。骨髓涂片:浆细胞均明显
Multiple myeloma nephropathy refers to the tumor cell infiltration and the resulting large number of abnormal immune globulin excreted from the urine caused by renal disease, the main symptom of proteinuria, easily misdiagnosed. The hospital from 1985 to 1992 admitted 7 cases of patients reported as follows: 1 clinical data of 4 males and 3 females. Age 38 ~ 67 years old. Both proteinuria and anemia, lower extremity edema, bone pain in 2 cases, 4 cases of hypertension, fever in 3 cases, repeated lung infection in 2 cases, hepatosplenomegaly in 2 cases. Total urinary protein 4.2 ~ 17g / 24h, 2 cases of microscopic hematuria, tubular urination in 4 cases. Urine this week’s protein are negative. Urine immunoelectrophoresis IgG4 cases, IgA3 cases. HLO 31 ~ 64L, white blood cells and thrombocytopenia in 1 case. ESR 58 ~ 113mm / h. 2 cases of normal and severe renal damage, 3 cases of moderate damage, 5 cases of elevated serum uric acid. Aminotransferase were normal, r globulin, globulin were elevated, A / G are inverted, 5 cases of M band, HBsAg positive in 2 cases. Immunoglobulin IgG increased in 4 cases, IgA increased in 3 cases. B ultrasound examination of hepatosplenomegaly in 2 cases. Skull and / or pelvis scattered in the tooth-like change in 5 cases. Bone marrow smear: plasma cells were significantly