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多发性骨髓瘤临床表现多样,易于误诊.本例多发性骨髓瘤以腹泻为主要临床表现,现报道如下.患者,女性,62岁,因反复腹痛、腹泻、粘液便3个月,加重2周,于1997年12月入院.患者3个月前无明显诱因出现上腹隐痛,呈持续性,以空腹时为重,伴腹泻、粘液脓样便,每日约10次,伴泛酸、嗳气、恶心、呕吐,无呕血及黑便,无腹痛-腹泻-疼痛缓解规律,无发热及肝区疼痛,曾入消化内科,因患者拒绝做纤维结肠镜故疑诊为溃疡性结肠炎.给予消炎、对症治疗,病情未见好转.近1周腹泻加重,呈水样便,每日约30次,伴里急后重,双下肢浮肿.既往患类风湿性关节炎30年,双手及腕关节畸形.体检:体温36.5℃,血压18/12kPa,体形消瘦,贫血貌,未见皮疹,全身浅表淋巴结未触及
Multiple myeloma clinical manifestations of diverse, easy to misdiagnosis .Multiple myeloma with diarrhea as the main clinical manifestations, are reported as follows.Patients, females, aged 62, due to repeated abdominal pain, diarrhea, mucus will be 3 months, an increase of 2 weeks Was admitted to hospital in December 1997. The patient developed obsessive upper abdominal pain no evidence of obstruction 3 months prior and was persistent with fasting, diarrhea and mucopurulent pus, about 10 times daily with pantothenic acid, Nausea and vomiting, no hematemesis and melena, no abdominal pain - diarrhea - the rule of pain relief, no fever and liver pain, had entered the digestive medicine, because the patient refused to do fiber colonoscopy suspected diagnosis of ulcerative colitis. Given anti-inflammatory, Symptomatic treatment, the condition did not improve .Driven week, diarrhea aggravated, was watery stool, about 30 times a day, with tenesmus, lower extremity edema .Former rheumatoid arthritis 30 years, hands and wrist deformities. Physical examination: Body temperature 36.5 ℃, blood pressure 18 / 12kPa, body weight loss, anemia appearance, no rash, systemic superficial lymph nodes not touched