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多发性骨髓瘤临床上少见,症状多隐匿或不典型,常易误诊或漏诊。现将我院误诊的4例报告如下。例1:男,60岁。因腰痛伴全身乏力1个月入院。血压16/10.7kPa,心肺正常,双侧肾区叩痛(+),余均正常。血红蛋白80g/L,血白细胞4×10~9/L,中性0.80,淋巴0.20。尿蛋白(++),白细胞1～2/HP,颗粒管型1～2/HP。尿素氮10.71mmol/L。眼底检查正常。诊为慢性肾炎、肾功能不全。入院后腰痛日渐加重,住院1个月后在外院骨髓检查确诊为多发性骨髓瘤。本例误诊的主要原因是对本病缺乏认识。多发性骨髓瘤由于浆细胞病理性增生,所以引起异常免疫球蛋白增多而产生肾脏损害,出现蛋白尿、管型尿等,亦可因凝溶蛋白沉着于肾小管产生肾功衰竭,这是肾型
Multiple myeloma is clinically rare, the symptoms are more occult or atypical, often misdiagnosed or missed diagnosis. Now misdiagnosed in our hospital 4 cases are as follows. Example 1: Male, 60 years old. Due to low back pain with malaise 1 month admission. Blood pressure 16 / 10.7kPa, normal heart and lung, bilateral renal area percussion pain (+), I were normal. Hemoglobin 80g / L, white blood cells 4 × 10 ~ 9 / L, neutral 0.80, lymph 0.20. Urinary protein (++), leukocytes 1 ~ 2 / HP, granular tube 1 ~ 2 / HP. Urea nitrogen 10.71 mmol / L. Fundus examination is normal. Diagnosed as chronic nephritis, renal insufficiency. Low back pain after admission is aggravating. One month after hospitalization, myeloma is diagnosed as multiple myeloma in the bone marrow of the hospital. The main reason for misdiagnosis in this case is the lack of understanding of the disease. Multiple myeloma due to pathological hyperplasia of plasma cells, resulting in increased abnormal immunoglobulin and kidney damage, proteinuria, tubular urine, etc., can also be due to coagulation protein deposition in the renal tubular renal failure, which is kidney type