1例多发性骨髓瘤治疗期间并发垂体危象

徐笑笑; 马中书; 于泳; 张连郁; 刘佩芳; 张鹏宇; 房淑霞; 张翼鷟

doi:10.3969/j.issn.1000-8179.20130752

1例多发性骨髓瘤治疗期间并发垂体危象

doi: 10.3969/j.issn.1000-8179.20130752

徐笑笑^①,
马中书^②,
于泳^①,
张连郁^③,
刘佩芳^④,
张鹏宇^⑤,
房淑霞^⑥,
张翼鷟^①, ,

①.
天津医科大学肿瘤医院血液科，国家肿瘤临床医学研究中心，天津市肿瘤防治重点实验室（天津市300060）
②.
天津医科大学总医院内分泌科
③.
天津医科大学肿瘤医院病理科，国家肿瘤临床医学研究中心，天津市肿瘤防治重点实验室（天津市300060）
④.
天津医科大学肿瘤医院放射科，国家肿瘤临床医学研究中心，天津市肿瘤防治重点实验室（天津市300060）
⑤.
天津医科大学肿瘤医院检验科，国家肿瘤临床医学研究中心，天津市肿瘤防治重点实验室（天津市300060）
⑥.
天津医科大学总医院消化内科

详细信息

通讯作者:
张翼鷟 yizhuozhang111@163.com

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- 被引次数: 0
出版历程
- 收稿日期: 2013-05-14
- 修回日期: 2013-08-21

Pituitary crisis in a multiple myeloma patient during treatment

Xiaoxiao XU^①,
Zhongshu MA^②,
Yong YU^①,
Lianyu ZHANG^③,
Peifang LIU^④,
Pengyu ZHANG^⑤,
Shuxia FANG^⑥,
Yizhuo ZHANG^{①
, ,}

①.
Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin 300060, China
②.
Department of Edocrinology, Genceral Hospital Affiloated to Tianjin Medical University, Tianjin 300052, China
③.
Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
④.
Department of Radiation, Tianjin Medical University Cnacer Institute and Hospital, Tianjin 300060, China
⑤.
Department of Laboratory, Tianjin Medical University Cnacer Institute and Hospital, Tianjin 300060, China
⑥.
Department of Gastroenterology, General Hospital Affiliated to Tianjin Medical University, Tianjin 300052 China

More Information

Corresponding author: Yizhuo ZHANG, E-mail: yizhuozhang111@163.com

摘要

摘要: 多发性骨髓瘤（myltiple myeloma, MM）是一种老年病，治疗原则以化疗为主。然而化学治疗相关的不良反应与希恩综合征的临床表现相似，对于无明确产后出血史的老年患者，往往容易造成误诊、漏诊。因此，老年多产的女性，在化疗期间出现顽固性低钠血症及消化道反应时，应考虑希恩综合征的可能，早期明确诊断，及时给予个体化治疗。
- 多发性骨髓瘤 /
- 希恩综合征 /
- 个体化治疗 /
- 多学科协作
Abstract: Multiple myeloma is common in the older population and is treated mainly with chemotherapy. However, chemotherapy-related side effects imitate the clinical manifestations of Sheehan's syndrome, which leads to misdiagnosis and missed diagnosis, particularly for older patients without a clear history of postpartum hemorrhage. Therefore, when older women with malignant myelomas show refractory hyponatremia and gastrointestinal disorders while under chemotherapy, a diagnosis of Sheehan's syndrome should be considered. The early detection of the disorder will guarantee timely individualized treatment.
- multiple myeloma /
- Sheehan's syndrome /
- individualized treatment /
- multidisciplinary team

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图 1 PET-CT：左侧第8肋骨质膨胀、破坏，显示放射性浓聚

Figure 1. PET-CT: damage and high fluorodeoxyglucose (FDG) uptake were observed in the left rib 8

下载: 全尺寸图片幻灯片

图 2 颅脑CT：颅骨多发低密度小结节，呈“穿凿样”骨破坏

Figure 2. Craniocerebral CT: multiple low-density nodules in the skull, which shows osteolytic bone destruction

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图 3 头颅MRI平扫：提示空蝶鞍

Figure 3. MRI plan scan: empty sella

A: T1WI; B: T1WI; C: T2W1

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图 4 PET-CT：蝶鞍密度减低，PET-CT显像未见放射性浓聚

Figure 4. PET-CT: low density in the sella turcica, which shows no FDG uptake

下载: 全尺寸图片幻灯片

参考文献(16)

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