• 제목/요약/키워드: 다발골수종

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다발골수종으로 청구한 무증상다발골수종 클레임의료자문 증례 (Smoldering multiple myeloma which was claimed for multiple myeloma : a case report of medical claims review)

  • 이신형
    • 보험의학회지
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    • 제29권2호
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    • pp.33-35
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    • 2010
  • Multiple myeloma is characterized by the neoplastic proliferation of a single clone of plasma cells producing a monoclonal immunoglobulin and it is frequently associated with primary amyloidosis. I experienced a medical claims review case of plasma cell dyscrasia with primary amyloidosis. This medical consulting work to insurance claims will be helpful for another similar claims administration.

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하악골에 발생한 다발성골수종의 증례보고 (MULTIPLE MYELOMA OF MANDIBLE : REPORT OF A CASE)

  • 장현석;이기철
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제18권4호
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    • pp.706-711
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    • 1996
  • 다발성 골수증은 다양한 증세를 보이는 형질세포로부터 기원하는 악성종양으로 40세이상의 남성에서 호발되며 alkylating agent 단독, 혹은 corticosteroid와 병용하는 항암제 치료로 생존율이 크게 증가되기는 하였지만 치료후 평균생존기간의 20개월 내외로 완치율이 그다지 높지않은 형편이다. 악골에서의 발생은 극히 드물고 대개 늑골, 편평골, 척추, 골반, 두개골등에 광범위한 patchy destruction의 형태로 나타나는데 악골에 발생할 경우 임상증상은 장기적인 무통성 종창이 가장 흔하며 때로는 동통, 악골의 팽창, 감각이상, 치아의 동요, 악골골절등을 보이기도 한다. 전신적증상으로 무력감, 체중감소, 빈혈, 신부전, hypercalcemia, hyperiviscosity syndrome을 나타내기도 하는데 약 10%의 환자에서 전신적인 amyloidosis를 보인다. 진단은 골수생검상 골수의 plasmacytosis가 10% 이상이면서 혈장이나 뇨전기영동법에서 monoclonal globulin peak이 있을 때 가능하다. 여러 학자들은 처음에는 독립적인 고립성병소로 나타났다가 장기적으로 다발성골수종으로 이행됨을 주장하면서 장기적인 추적을 권하고 있지만 골내 고립성 형질세포종(solitary plasmacytoma in bone), 수질외 형질세포종(extramedullary plasmacytoma) 등은 다발성골수종과는 다른 질환이라 주장하는 등 아직 많은 논란이 있는 형편이다. 치료는 $4000{\sim}6000$ rad의 방사선치료와 여러 가지 약제의 복합적인 항암요법이 사용되고 있으며 국소적인 병소의 경우 외과적 절제술이 추천되기도 한다. 저자들은 59세 여자환자에서 하악골에 발생된 다발성골수종을 치험하였기에 문헌고찰과 함께 보고하는 바이다.

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파노라마방사선영상에서 관찰되는 다발골수종: 증례보고 (Multiple myeloma: Report of two cases with emphasis on the panoramic imaging features)

  • 염한결
    • 대한치과의사협회지
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    • 제56권12호
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    • pp.707-713
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    • 2018
  • Multiple myeloma is a lymphohematopoietic disorder leading to abnormal hemostasis and significant pathologic changes of skeletal system. It induces multiple circular or oval-shaped radiolucent lesions which are characterized by 'punched-out appearance'. The surrounding trabecular bone normally shows no significant sclerotic reaction. Multiple myeloma patients may visit dental clinics, without perception of the disease themselves, due to discomfort from edema of orofacial region, oral ulcers, tooth mobility, pain or gingival bleeding. Multiple myeloma is susceptible to various complications, including delayed hemostasis and infection, which could occur during routine dental treatment such as periodontal and surgical operation. For radiographic diagnosis of multiple myeloma, common radiologic features of this tumor could be visualized by panoramic radiographs in the dental clinics, and further medical examinations and treatment can be recommended as a result.

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기립불능증으로 발현한 다발골수종과 연관된 아밀로이드증 (Myeloma-associated Amyloidosis Presenting as Orthostatic Intolerance)

  • 정희정;남원식;손승남;김수경;강희영;최낙천;권오영;임병훈;박기종
    • Annals of Clinical Neurophysiology
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    • 제17권1호
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    • pp.24-27
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    • 2015
  • Amyloidosis is a systemic disorder associated with clonal plasma cell dyscrasia. Nephrotic syndrome, congestive heart failure, autonomic and peripheral neuropathy is often associated features in amyloidosis. Early diagnosis is most important because of different prognosis by stage. The diagnosis can be delayed since symptoms of amyloidosis may vary or nonspecific. We describe a patient of myeloma-associated amyloidosis, who showed orthostatic intolerance as the first symptom of the disease.

아밀로이드증을 동반한 다발골수종 환자의 자가말초혈액조혈모세포 이식 전 유도항암화학요법 후 발생한 말초신경병증에 대한 복합 한의 치험 1례 (A Case Report of Peripheral Neuropathy after Induction Chemotherapy before Autologous Peripheral Blood Stem Cell Transplantation in a Patient with Multiple Myeloma with Amyloidosis Treated with Complex Korean Medicine Treatment)

  • 김마리아;이세연;구기범;남이랑;김민화;김소연
    • 대한한방내과학회지
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    • 제44권5호
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    • pp.1092-1100
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    • 2023
  • Introduction: We present a case of multiple myeloma with amyloidosis, which has features of peripheral neuropathy after induction chemotherapy before autologous peripheral blood stem cell transplantation, in a 56-year-old woman with Korean medicine. Case Presentation: For 17 days of hospitalization, the patient with complaints of numbness and a tingling sensation in the hands and feet was treated with acupuncture, herbal medicine. To reduce the symptoms, we provided Korean medicine treatments, including herbal medicine, acupuncture, and moxibustion. The Visual Analog Scale (VAS) was used to evaluate the results of the treatment. Until discharge, the VAS scores decreased for both hands and the foot tingling sensation. Conclusion: According to these results, Korean medicine treatment may be considered an effective treatment for tingling sensations in a patient with multiple myeloma with amyloidosis. Prospective studies are needed in the future to confirm and expand these findings.