• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>CEN Case Reports >Atypical sarcoidosis diagnosed by bone marrow biopsy during renal workup for possible multiple myeloma
【24h】

Atypical sarcoidosis diagnosed by bone marrow biopsy during renal workup for possible multiple myeloma

机译：肾脏检查期间骨髓活检诊断为可能的多发性骨髓瘤的非典型结节病

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Sarcoidosis is a multi-organ disease of unknown etiology characterized by non-caseating granulomas. Here we report the case of a 78-year-old white male with a past medical history of diabetes mellitus, hypertension, and chronic kidney disease stage III with a baseline serum creatinine of 2.5 mg/dl. The patient had a prior admission history for acute kidney injury (AKI) attributed to dehydration and medication-induced nephro-toxicities. He presented to the renal clinic for follow-up with acute worsening of chronic kidney failure with a serum creatinine level of 3.5 mg/dl. Examination revealed that he was anemic and mildly hypercalcemic with suppressed parathyroid hormone and had proteinuria of 1.3 g per day. The computed tomography scan of the abdomen revealed right renal pelvic non-obstructing calculi. Serum protein electrophoresis revealed gammopathy with two distinct monoclonal peaks consisting of immunoglobulin G (IgG) kappa and IgG lambda, respectively. The kappa/lambda ratio was within normal limits, and urine protein electrophoresis showed no evidence of a monoclonal peak or Bence Jones proteins. Further workup for multiple myeloma, including bone marrow (BM) biopsy, revealed polyclonal plasma cells and B cells with no clonality. No morphological and immune-phenotypic evidence of plasma cell dyscrasia was found, but BM biopsy did show numerous non-caseating granulomas consistent with sarcoidosis. Skin biopsy from non-scaly 6-mm skin colored papule also showed non-caseating granulomas. The patient had elevated angiotensin-converting enzyme levels (165 ug/l) and an erythrocyte sedimentation rate of 27 mm/h. Kidney biopsy did not show granulomas. The hypercalcemia, proteinuria, and AKI responded well after 2 weeks of 60 mg oral prednisone daily.
机译：结节病是一种病因不明的多器官疾病，其特征为非干酪性肉芽肿。在这里，我们报告了一位78岁的白人男性，该患者过去有糖尿病，高血压和慢性肾脏疾病III期的病史，基线血肌酐为2.5 mg / dl。该患者因脱水和药物引起的肾毒性而有急性肾损伤（AKI）的入院史。他出现在肾脏诊所进行随访，发现血清肌酐水平为3.5 mg / dl，导致慢性肾功能衰竭的急性恶化。检查显示他贫血，轻度高钙血症，甲状旁腺激素被抑制，每天尿蛋白1.3克。腹部电脑断层扫描显示右肾盂无阻塞性结石。血清蛋白电泳显示带有两个分别由免疫球蛋白G（IgG）kappa和IgG lambda组成的单克隆峰的丙种病。 κ/λ比在正常范围内，尿蛋白电泳未显示单克隆峰或Bence Jones蛋白的迹象。对多发性骨髓瘤的进一步检查，包括骨髓活检，发现多克隆浆细胞和无克隆性的B细胞。没有发现浆细胞发育不良的形态学和免疫表型证据，但BM活检确实显示出许多与结节病一致的非干酪性肉芽肿。非鳞状6毫米皮肤彩色丘疹的皮肤活检也显示非干酪性肉芽肿。该患者的血管紧张素转化酶水平升高（165μg/ l），红细胞沉降速率为27mm / h。肾脏活检未显示肉芽肿。每天口服60 mg泼尼松2周后，高钙血症，蛋白尿和AKI反应良好。

著录项

  • 来源
    《CEN Case Reports》 |2013年第1期|102-106|共5页
  • 作者

    Amr El-Husseini; Alberto J. Sabucedo; Jorge Lamarche; Craig Courville; Alfredo Peguero;

  • 作者单位

    James A. Haley Veterans Hospital University of South Florida">(1);

    Division of Nephrology Bone and Mineral Metabolism University of Kentucky Chandler Medical Center">(2);

    James A. Haley Veterans Hospital University of South Florida">(1);

    James A. Haley Veterans Hospital University of South Florida">(1);

    James A. Haley Veterans Hospital University of South Florida">(1);

    James A. Haley Veterans Hospital University of South Florida">(1);

  • 收录信息
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

    Sarcoidosis; Bone marrow; Proteinuria; Renal failure;

    机译：结节病;骨髓蛋白尿肾功能衰竭;

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号