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MR Vol.10 No.2 indexに戻る
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MODERN RHEUMATOLOGY
Vol.10 No.2 |
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Sjogren syndrome associated with multiple myeloma
of the IgA 3-type |
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| T. Akimoto1, S. Kobayashi1, N. Tamura1,
H. Bando1, M. Ikeda1, T. Fujii1, T. Hirano2, Y. Takasaki1, H. Hashimoto1 |
(1)Department of Rheumatology and Internal
Medicine, Juntendo University School of Medicine, 2-1-1 Hongo,
Bunkyo-ku, Tokyo 113-8421, Japan
(2)Department of Hematology, Juntendo University School of Medicine, Tokyo,
Japan |
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| Abstract |
| Abstract We report a case of a 62-year-old female
patient with Sjogren syndrome (SS) who developed multiple myeloma
(MM) of the IgA 3-type. In 1986, the patient was admitted to our
hospital with a facial rash, keratoconjunctivitis sicca, and xerostomia.
She was diagnosed as having discoid lupus erythematosus (DLE) and
SS. She was treated with bromhexine hydrochloride for SS and with
topical fluorinated steroid for DLE. In 1992, she developed compression
fractures of the lumbar vertebrae and was readmitted to our hospital.
DLE was not recognized. Laboratory findings revealed IgA 2046 mg/dl,
IgG 529 mg/dl, and IgM 21 mg/dl. Anti-SS-A antibody was 1 : 32 and
anti-SS-B antibody was 1 : 2. M protein of IgA 3 was demonstrated
by immunoelectrophoresis. Aspiration biopsy of the bone marrow revealed
20.2% plasma cells. A bone scintigram demonstrated many hot spots
at the cervical and lumbar vertebrae. She was diagnosed as having
SS and MM of the IgA 3-type. After chemotherapy for MM, the percentage
of plasma cells in the bone marrow and the concentration of serum
IgA decreased to 6.2% and 532 mg/dl, respectively. SS is frequently
associated with benign monoclonal gammopathy or lymphoproliferative
disorders, especially Waldenstrom's macroglobulinemia or malignant
lymphoma. Although benign monoclonal gammopathy has frequently been
observed in patients with SS, SS associated with MM is extremely
rare. |
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| Key words |
| Key words Sjogren syndrome ・ Multiple myeloma
・ Lymphoma ・ Gammopathy macroglobulinemia |
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