[On the diagnosis of multiple myeloma an analysis of 2,547 domestic cases].
Analysis of 2,547 cases of multiple myeloma (MM) reported in China in 1980s showed that the clinical manifestations are characterized by multipliey. High misdiagnosis rate (69%) and multiple complications. While the monoclonal protein had more than 25 immunological type, IgG myeloma was the commonest (43.1%). Light chain subgroup trended to have higher incidence of renal damage (76.9%). Plasma cell leukemia eventually developed in 30 cases. In order to improve diagnosis and avoid misdiagnosis, the key points are 1, to better the recognition of clinical features of MM. 2. patient should receive urine Bence-Jones protein, immunoglobulins, immunoeletrophresis, bone X-ray and multiple site bone marrow puncture whenever one of such manifestations as unexplained anemia, skeletal pain, proteinuria, elevation of ESR, hyperviscosity syndrome, hypercalcemia, hyperuricemia, elevation of alkaline phosphatase, pathological fractures and diffuse osteoporosis. 3. immuno-binding electrophoresis and immunofluorence antibody detection should be done for suspected cases with normal immunoglobulin level.
Li
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Department of Internal Medicine, Beijing Tong Ren Hospital.
Li
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Zhao
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D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000145:classification / Q000175:diagnosis*