An Observation of Plasma Cell Dyscrasia Developing to Multiple Myeloma With a Rare Association of Pituitary Adenoma and Pituitary Apoplexy

概要

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A 67 year-old male showed clinical manifestations of two different disorders in his clinical course for more than 20 years. In fact, he started his complaint of headache at the age of 27, when he was hypertensive. Acromegaly was noted at the age of 33 and glucosuria at the age of 42. Clinical manifestations at the age of 45 included general fatigue, thirst, polydipsia-polyuria, and impotence. A clinical examinations made a diagnosis of. Pituitary adenoma. At the age of 47, an episode of severe headache- with fever for 10 days made him normotensive and panhypopituitarism, indicating pituitary apoplexy. In his clinical course, however, there was another manifestation of serum monoclonal immunoglobulin of IgG(k) type. On the basis of low plasma cell proliferation, and low concentration of M-protein, benign monoclonal gammopathy was a diagnosis at that time. After the following 14 years, changes from benign monoclonal gammopathy to multiple myeloma were noted. The patient died of exacerbated malignant state of myeloma, hypercalcemia, anemia, associated DIC and generalized infections. Two different course of two different disorders were discussed, in connection with clinical and pathological findings.
神戸大学の論文
1998-12-26