[Overview]
Myeloma of the much bone that send a gender is one kind has tumor sex disease of the gender, the globulin of odd clone immunity that its feature is tumour of medullary oar cell and integrality of one individual plant (IgG, igA, igD or IgE) or Bence Jones protein (small chain of the κ of odd clone sex of free or γ ) excessive hyperplasia, often accompany sex of bone of the much dissolve that send a gender is damaged, disease of tall calcic blood, anaemic, the kidney is damaged, and the easy perceptual heighten that affects to bacterial sex, of normal immunity globulin generate suffer curb. Estimation of incidence of a disease is 2~3/10 10 thousand, scale of male and female is 1.6:1, mostly patient age ＞ is 40 years old.
[The pathogeny learns]
The pathogeny is unidentified. The tree that fosters in medullary tumour patient dash forward in shape cell, discovered with Kaboxi the herpes virus related sarcoma, this hints both existence is contacted certainly. The Bai Jiesu that this virus codes - the homologue of 6(IL-6) . Human IL-6 can promote medullary tumour to grow, absorb what stimulate bone at the same time again.
This kind of special cell origin is still indistinct. The gene series that passes immune globulin and clew of analysis of cellular surface mark send central cell for have a youthful look malign change and come.
The pathogeny of this disease has not clarify completely. Animal model and clinical observation hint, familial history, infection of radiate of stimulation of genetic easy sensibility, chronic antigen, ionization, virus is likely come on with this disease about.
[Clinical expression]
Durative indecipherable skeleton is aching (be in especially back or pectoral outline) , kidney function fails, produce bacterial sex appeal to catch repeatedly (especially pneumococcus sex is pneumonic) be most the symptom that often appears. Pathology sex fracture and vertebra are compressed common, latter likelihood brings about approach of spinal cord press press and paraplegia. Because be in,kidney canaliculus is in charge of extensively model form, epithelial atrophy mixes kidney canaliculus a qualitative fiber change and produce kidney to decline () of medullary tumour nephrosis. Some patients with anaemia, companion is lack of power give priority to with exhaustion, a few patient has stick sluggish high to be asked for integratedly (see above paragraphs is gigantic) of globulin blood disease. Lymph node and liver splenomegaly are not common.
[Diagnose]
The diagnostic standard of medullary tumour is, put in the patient of serum M albumen, have following in 3 disease elephant any: Cell of the oar in marrow is become piece or Cheng Cong; Dissolve bone is venereal caustic (eliminate to transfer sexual tumour or granulation swollen disease) or this - week albuminuria ＞ 300mg/24h.
Haemal examination is orthochromatic element cellular sex is anaemic, outside week blood piece in apparent money is strung together form a phenomenon. Leucocyte and plaque computation constant normal.ESR often is accelerated apparently, sometimes but ＞ 100mm/h. Nitrogen of element of blood in the urine, serum flesh acid and acid of serum make water constant heighten. Some patients are put in low anion clearance. The patient of first visit to a doctor that has 10% about produces disease of tall calcic blood. Small globulin of serum β 2 - constant heighten and related to bump of oar cell tumour.
Previous12 Next