下顎骨に初発症状を呈し, 急性腎障害をきたした多発性骨髄腫の1例

• Published in: 日本口腔外科学会雑誌 Vol. 67; no. 6; pp. 340 - 345
• Main Authors: 大山, 定男, 長谷川, 稔洋, 名島, 悠峰, 小川, 千晴, 安井, 佑太, 家崎, 憲博
• Format: Journal Article
• Language: Japanese
• Published: 社団法人 日本口腔外科学会 20.06.2021
• Subjects: 下顎骨; 初発症状; 多発性骨髄腫; 急性腎障害; 血液透析
• ISSN: 0021-5163; 2186-1579
• DOI: 10.5794/jjoms.67.340

Multiple myeloma (MM) is a disease characterized by a plasmocytic monoclonal proliferation and an increase in the serum and/or urine of monoclonal immunoglobulin (M-protein) produced. Therefore, it presents various clinical symptoms. We report a case of an MM patient who presented a primary symptom in the mandible, leading to acute kidney injury (AKI). A 75-year-old man was referred to our department as mandibular malignancy was suspected in another hospital. We performed a biopsy to make a definitive diagnosis. Ten days after the biopsy, he was referred for emergency treatment due to fatigue and oral feeding difficulty. A blood examination showed AKI of Cr 13.92 mg/dL. The biopsy result was undetermined, and when checked with a pathologist, a plasma cell tumor was suspected. First, we consulted a nephrologist and he started emergency hemodialysis under hospitalization. Since AKI due to MM was suspected, we then consulted a hematologist and performed additional examinations. The results led to a definitive diagnosis of symptomatic MM (IgG-λ). High-dose dexamethasone therapy was commenced immediately. The treatment was very effective, and hemodialysis was stopped. Nineteen months after the primary therapy, he has been continuing chemotherapy in another hospital, with good ADL.