高度の蛋白尿で発見された多発性骨髄腫の1例

Abstract

A 70-year-old woman was admitted to our hospital for close examination of massive proteinuria. Physical examination was negative ; normal blood pressure and no pretibial edema. Pertinent laboratory data revealed mild anemia, leukocytopenia and decreased levels of serum IgG, IgA and IgM. A 24-h urine collection contained 8.2g of Bence Jones protein (κ type) and 0.74 g of albumin. Bone marrow aspiratien revealed 48.4 % of atypical plasma cells. Bone destruction was not detected in the bone survey of either radiography or scintigraphy. She was diagnosed as having multiple myeloma (Bence Jones type) without bone involvement. Renal biopsy showed minor glomerular abnormalities and small foci of tubular atrophy and fibrosis. Neither amyloid deposition nor casts were observed. The patient is a rare case that was incidentally found to have multiple myeloma by urinalysis. One should be reminded of this case when an old patient has massive protemurla.