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
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...
Saved in:
| Published in | 日本口腔外科学会雑誌 Vol. 67; no. 6; pp. 340 - 345 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
社団法人 日本口腔外科学会
20.06.2021
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0021-5163 2186-1579 |
| DOI | 10.5794/jjoms.67.340 |
Cover
| Abstract | 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. |
|---|---|
| AbstractList | 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. |
| Author | 安井, 佑太 長谷川, 稔洋 大山, 定男 名島, 悠峰 家崎, 憲博 小川, 千晴 |
| Author_xml | – sequence: 1 fullname: 大山, 定男 organization: がん・感染症センター都立駒込病院歯科口腔外科 – sequence: 1 fullname: 長谷川, 稔洋 organization: がん・感染症センター都立駒込病院歯科口腔外科 – sequence: 1 fullname: 名島, 悠峰 organization: がん・感染症センター都立駒込病院血液内科 – sequence: 1 fullname: 小川, 千晴 organization: がん・感染症センター都立駒込病院歯科口腔外科 – sequence: 1 fullname: 安井, 佑太 organization: がん・感染症センター都立駒込病院歯科口腔外科 – sequence: 1 fullname: 家崎, 憲博 organization: 自治医科大学附属さいたま医療センター歯科口腔外科 |
| BookMark | eNrjYmDJy89LZWAQMTTQMzW3NNHPysrPLdYzM9czNjFgYuA0MrQw0zUEyrAwcBoYGBnqmhqaGXMw8BYXZyYZGJhamFuaG5txMkQ92dH9cmHfy1UrHjeuftox9_nMXc-ntz_v2va4adLTiR2PG6frKDxrWPqsYfmL1r6Xs-Y8XbcZKPO4sfdx43ygJJB8umQWUBNQAdCMl6tbXrSufty4zvDJvm4eBta0xJziVF4ozc0Q6uYa4uyh6-Pv7uns6KObZWRsYKKbkmacbGRgmGZgYZqcZmBpmWxpZm5iap6WYmZikmpunGRiYZaamJRskphmDiRMLQwski2BMiZAXYZJRqnJxtwM9hBzs4pLEtNT4wuKMnMTiyrjE4tKMpNzUuPBARNvZh5vBiKAoQOXSc5ILIrPSjQGAOnXfmw |
| ContentType | Journal Article |
| Copyright | 2021 社団法人 日本口腔外科学会 |
| Copyright_xml | – notice: 2021 社団法人 日本口腔外科学会 |
| DOI | 10.5794/jjoms.67.340 |
| DatabaseTitleList | |
| DeliveryMethod | fulltext_linktorsrc |
| EISSN | 2186-1579 |
| EndPage | 345 |
| ExternalDocumentID | article_jjoms_67_6_67_340_article_char_ja |
| GroupedDBID | ALMA_UNASSIGNED_HOLDINGS F5P JSF KQ8 RJT |
| ID | FETCH-LOGICAL-j2304-df3c201f085cf099c967457fd644e73b486eabc4af7c4a5808c944e43c21b2ec3 |
| ISSN | 0021-5163 |
| IngestDate | Wed Sep 03 06:31:11 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | false |
| IsScholarly | true |
| Issue | 6 |
| Language | Japanese |
| LinkModel | OpenURL |
| MergedId | FETCHMERGED-LOGICAL-j2304-df3c201f085cf099c967457fd644e73b486eabc4af7c4a5808c944e43c21b2ec3 |
| OpenAccessLink | https://www.jstage.jst.go.jp/article/jjoms/67/6/67_340/_article/-char/ja |
| PageCount | 6 |
| ParticipantIDs | jstage_primary_article_jjoms_67_6_67_340_article_char_ja |
| PublicationCentury | 2000 |
| PublicationDate | 2021/06/20 |
| PublicationDateYYYYMMDD | 2021-06-20 |
| PublicationDate_xml | – month: 06 year: 2021 text: 2021/06/20 day: 20 |
| PublicationDecade | 2020 |
| PublicationTitle | 日本口腔外科学会雑誌 |
| PublicationTitleAlternate | 日口外誌 |
| PublicationYear | 2021 |
| Publisher | 社団法人 日本口腔外科学会 |
| Publisher_xml | – name: 社団法人 日本口腔外科学会 |
| References | 9) 酒向 誠， 村田千年， 他：AA 蛋白による舌アミロイドーシスが先行症状であった多発性骨髄腫の1例．日口外誌 50: 616-619, 2004. 17) 川邊万佑子， 山本 泉， 他：Myeloma cast nephropathyに対する最適な治療戦略．日透析療会誌 50: 76-78, 2017. 18) 八重垣健， 亀山忠光， 他：顎口腔領域に初発症状を呈した多発性骨髄腫の臨床統計学的研究－本邦ならびに外国報告の集計－．日口外誌 29: 2266-2272, 1983. 19) Zhao XJ, Sun J, et al : Maxillary pain is the first indication of the presence of multiple myeloma : A case report. Mol Clin Oncol 2: 59-64, 2014. 13) 吉田篤博， 両角國男， 他：血液透析療法を必要とした多発性骨髄腫症例の検討−長期生存の2例を中心に−．日透析療会誌 24: 443-448, 1991. 10) 岡田成生， 神部芳則， 他：舌のアミロイドーシスから診断された多発性骨髄腫の1例．日口腔内会誌 22: 84-87, 2016. 1) 飯田真介， 安倍正博， 他：多発性骨髄腫．中尾眞二；造血器腫瘍診療ガイドライン2018年版．第2版， 金原出版， 東京， 2018， 320-382 頁 20) Goetze E, Walter C, et al : Osseous Plasma Cell Neoplasm of the Mandible for Initial Diagnosis of Multiple Myeloma : Case Report and Literature. J Maxillofac Oral Surg 14: S469-S474, 2015. 4) 今井裕一， 三浦直人：血液疾患で生じる急性腎障害．日内会誌 103: 1108-1115, 2014. 8) 三上有史， 小川隆嗣， 他：オトガイ下部腫脹を主訴とした多発性骨髄腫に合併したアミロイドーシスの1例．日口外誌 32: 2371-2376, 1986. 11) 兵頭誠治， 米本嘉憲， 他：舌および頰粘膜アミロイドーシスが初発症状であった多発性骨髄腫の1例．日口診誌 31: 146-150, 2018. 2) 黒田純也：多発性骨髄腫の診療2018．松仁会医誌 58: 1-9, 2018. 15) 小木幸人， 今田聰雄， 他：腎不全を呈した多発性骨髄腫の検討．日透析療会誌 22: 399-403, 1989. 12) 内田満美子， 鎌田貢寿， 他：多発性骨髄腫の腎機能障害に関する臨床的統計．北里医 24: 501-512, 1994. 16) 成山真一， 飯田正人， 他：ボルテゾミブとデキサメサゾン併用療法が奏功し血液透析から離脱できた急性腎不全合併Bence-Jones型多発性骨髄腫の1例．日透析療会誌 44: 1023-1029, 2011. 6) 水野真一：多発性骨髄腫の腎病変MGRS．日内会誌 105: 1224-1230, 2016. 3) Hutchison CA, Bradwell AR, et al : Treatment of acute renal failure secondary to multiple myeloma with chemotherapy and extended high cut-off hemodialysis. Clin J Am Soc Nephrol 4: 745-754, 2009. 7) Rajkumar SV, Dimopoulos MA, et al : International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol 15: 538-548, 2014. 14) Hutchison CA, Cockwell P, et al : Early reduction of serum-free light chains associates with renal recovery in myeloma kidney. J Am Soc Nephrol 22: 1129-1136, 2011. 5) 高橋直人：多発性骨髄腫と腎障害．日臨 73: 38-41, 2015. |
| References_xml | – reference: 4) 今井裕一， 三浦直人：血液疾患で生じる急性腎障害．日内会誌 103: 1108-1115, 2014. – reference: 12) 内田満美子， 鎌田貢寿， 他：多発性骨髄腫の腎機能障害に関する臨床的統計．北里医 24: 501-512, 1994. – reference: 9) 酒向 誠， 村田千年， 他：AA 蛋白による舌アミロイドーシスが先行症状であった多発性骨髄腫の1例．日口外誌 50: 616-619, 2004. – reference: 17) 川邊万佑子， 山本 泉， 他：Myeloma cast nephropathyに対する最適な治療戦略．日透析療会誌 50: 76-78, 2017. – reference: 8) 三上有史， 小川隆嗣， 他：オトガイ下部腫脹を主訴とした多発性骨髄腫に合併したアミロイドーシスの1例．日口外誌 32: 2371-2376, 1986. – reference: 18) 八重垣健， 亀山忠光， 他：顎口腔領域に初発症状を呈した多発性骨髄腫の臨床統計学的研究－本邦ならびに外国報告の集計－．日口外誌 29: 2266-2272, 1983. – reference: 19) Zhao XJ, Sun J, et al : Maxillary pain is the first indication of the presence of multiple myeloma : A case report. Mol Clin Oncol 2: 59-64, 2014. – reference: 20) Goetze E, Walter C, et al : Osseous Plasma Cell Neoplasm of the Mandible for Initial Diagnosis of Multiple Myeloma : Case Report and Literature. J Maxillofac Oral Surg 14: S469-S474, 2015. – reference: 2) 黒田純也：多発性骨髄腫の診療2018．松仁会医誌 58: 1-9, 2018. – reference: 14) Hutchison CA, Cockwell P, et al : Early reduction of serum-free light chains associates with renal recovery in myeloma kidney. J Am Soc Nephrol 22: 1129-1136, 2011. – reference: 15) 小木幸人， 今田聰雄， 他：腎不全を呈した多発性骨髄腫の検討．日透析療会誌 22: 399-403, 1989. – reference: 6) 水野真一：多発性骨髄腫の腎病変MGRS．日内会誌 105: 1224-1230, 2016. – reference: 1) 飯田真介， 安倍正博， 他：多発性骨髄腫．中尾眞二；造血器腫瘍診療ガイドライン2018年版．第2版， 金原出版， 東京， 2018， 320-382 頁． – reference: 5) 高橋直人：多発性骨髄腫と腎障害．日臨 73: 38-41, 2015. – reference: 11) 兵頭誠治， 米本嘉憲， 他：舌および頰粘膜アミロイドーシスが初発症状であった多発性骨髄腫の1例．日口診誌 31: 146-150, 2018. – reference: 16) 成山真一， 飯田正人， 他：ボルテゾミブとデキサメサゾン併用療法が奏功し血液透析から離脱できた急性腎不全合併Bence-Jones型多発性骨髄腫の1例．日透析療会誌 44: 1023-1029, 2011. – reference: 3) Hutchison CA, Bradwell AR, et al : Treatment of acute renal failure secondary to multiple myeloma with chemotherapy and extended high cut-off hemodialysis. Clin J Am Soc Nephrol 4: 745-754, 2009. – reference: 7) Rajkumar SV, Dimopoulos MA, et al : International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol 15: 538-548, 2014. – reference: 13) 吉田篤博， 両角國男， 他：血液透析療法を必要とした多発性骨髄腫症例の検討−長期生存の2例を中心に−．日透析療会誌 24: 443-448, 1991. – reference: 10) 岡田成生， 神部芳則， 他：舌のアミロイドーシスから診断された多発性骨髄腫の1例．日口腔内会誌 22: 84-87, 2016. |
| SSID | ssib005879736 ssib058493840 ssj0001742264 ssib000940266 |
| Score | 2.2696347 |
| Snippet | Multiple myeloma (MM) is a disease characterized by a plasmocytic monoclonal proliferation and an increase in the serum and/or urine of monoclonal... |
| SourceID | jstage |
| SourceType | Publisher |
| StartPage | 340 |
| SubjectTerms | 下顎骨 初発症状 多発性骨髄腫 急性腎障害 血液透析 |
| Title | 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 |
| URI | https://www.jstage.jst.go.jp/article/jjoms/67/6/67_340/_article/-char/ja |
| Volume | 67 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| ispartofPNX | 日本口腔外科学会雑誌, 2021/06/20, Vol.67(6), pp.340-345 |
| journalDatabaseRights | – providerCode: PRVAFT databaseName: Open Access Digital Library customDbUrl: eissn: 2186-1579 dateEnd: 99991231 omitProxy: true ssIdentifier: ssj0001742264 issn: 0021-5163 databaseCode: KQ8 dateStart: 19670101 isFulltext: true titleUrlDefault: http://grweb.coalliance.org/oadl/oadl.html providerName: Colorado Alliance of Research Libraries |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV1JaxRBFG5CvHgRRcWdHKxT7NhLrcfqSQ9BUVASCF6a7k73YcAkaHLxlBGDwWBAL8GgiKAoBnIRRDz4ZyaTZP6F71Uv0wYPMQihqKl673vb9FS9Ti2WdZ3xOcoyn9p5Bg855UluyzjPbMFymfg0YQnFzcl37vKpGXprls2OjN5vrFpaXkom0id_3VdynKhCG8QVd8n-Q2RrUGiAOsQXSogwlEeKMQkpCSSRAQkV0S6RoalooiUJfZgkEg1djEhJ1CQJBVGKBNpUBJECK1KTgBtijygPiZWL9AU7np_bGichxwURmlUV4ASprJSnNFEt5NQhCfwGloGQkxVWewg6bAEuighD5WoRtSUKzZC0FIomFbaFrnFACA5ozrERAmQU6oJm2ign20T7JYSilWCOgkEYGI0tk0Rzg9kyOoFtgemSqIqsXyiX3KgkI4GLf8ZNxgWlMQAihvSABJTGb4FjKuYjRMUwCrQTteIkoJU5pSDlGB8y9C2EqoqHR7RTtTpNesCX7UP4DCGkbxwCXqbNdz2eWZPmOfXTadQxfkXpgXEbRzlgAvoGvjF6_H85uTlqgibMLQeizLThVWa2y4qLgKqRtLhYpfzFaA6LfnEkVznD8osDRA8P3gBGcfDuLDx8PMHFRM30x3Ho5cMWGbKIi4hjAbRR1YPbFaMO5EwnPBjp8TqX2_caKYeijtdIYZgUSvj1Z5iPK786_8i8pxVmr3mxUqxwQ7F_BtW92VQW5rAdyOiq1aBmgjp92jpVZpZjutDvjDXSic9aD3Z_rA8-bAy-ful1t_tr7_bf_NzffL7_4nvv6ev-q7Ved_PG2N7Kp72VzwerG4Ott_2db9DT677sdd9DJ5T9j1vABASAMdh-drC63evuuLu_1s9ZM-1wujVll9ep2B38z489l_spTPdzSLLSHBLDVHFBmcjnICXKhJ9QybM4SWmcCyiYdGSqoIcCl5t4Weqft0bnF-azC9ZYnseCpiKJY0mpoFzFkAX6iqWQv-VZ5l60ZOGKaLE4Myc6ctguHZ_1snVy-NBcsUaXHi1nVyFlWEqume_AbxtO35I |
| linkProvider | Colorado Alliance of Research Libraries |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=%E4%B8%8B%E9%A1%8E%E9%AA%A8%E3%81%AB%E5%88%9D%E7%99%BA%E7%97%87%E7%8A%B6%E3%82%92%E5%91%88%E3%81%97%2C+%E6%80%A5%E6%80%A7%E8%85%8E%E9%9A%9C%E5%AE%B3%E3%82%92%E3%81%8D%E3%81%9F%E3%81%97%E3%81%9F%E5%A4%9A%E7%99%BA%E6%80%A7%E9%AA%A8%E9%AB%84%E8%85%AB%E3%81%AE1%E4%BE%8B&rft.jtitle=%E6%97%A5%E6%9C%AC%E5%8F%A3%E8%85%94%E5%A4%96%E7%A7%91%E5%AD%A6%E4%BC%9A%E9%9B%91%E8%AA%8C&rft.au=%E5%A4%A7%E5%B1%B1%2C+%E5%AE%9A%E7%94%B7&rft.au=%E9%95%B7%E8%B0%B7%E5%B7%9D%2C+%E7%A8%94%E6%B4%8B&rft.au=%E5%90%8D%E5%B3%B6%2C+%E6%82%A0%E5%B3%B0&rft.au=%E5%B0%8F%E5%B7%9D%2C+%E5%8D%83%E6%99%B4&rft.date=2021-06-20&rft.pub=%E7%A4%BE%E5%9B%A3%E6%B3%95%E4%BA%BA+%E6%97%A5%E6%9C%AC%E5%8F%A3%E8%85%94%E5%A4%96%E7%A7%91%E5%AD%A6%E4%BC%9A&rft.issn=0021-5163&rft.eissn=2186-1579&rft.volume=67&rft.issue=6&rft.spage=340&rft.epage=345&rft_id=info:doi/10.5794%2Fjjoms.67.340&rft.externalDocID=article_jjoms_67_6_67_340_article_char_ja |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0021-5163&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0021-5163&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0021-5163&client=summon |