Amyloid shoulder padsの1例

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To report a case of amyloid shoulder pads in the course of multiple myeloma. A 72 year-old male visited us with a 4-month history of swelling and pain in the left shoulder joint and both hip joints. The serum data revealed WBC 6580 /μl, negative CRP, TP6.6 g/dl, BUN32.9 mg/dl, Cr3.3 mg/dl, Ca10.3 mEq/L. CT scan showed the lesions of low ∼ iso density. MR images showed the lesions of high intensity on T2-weighted images. Open biopsy and drainage performed on the both hip joints showed a large amount of yellow-white deposit. The culture of the deposit was negative. Pathological diagnosis was the necrotic tissue. Postoperatively, Bence-Jones protein was positive and he was diagnosed as a multiple myeloma by a bone-marrow biopsy. The specimens taken from the left shoulder showed amyloid by Congo red staining and the left shoulder was diagnosed as amyloid arthropathy. Huvos et al. reported that the abnormal accumulation of amyloid could affect up to 25% of the patients with multiple myeloma. Fautrel et al. reported 3% of multiple myeloma cases developed amyloid arthropathy. And they reported 91% of the amyloid arthropathy cases were affected in the shoulder joint. A systemic treatment for multiple myeloma and local treatment were effective. Amyloid arthropathy with multiple myeloma should be considered, when patients have joint swelling without inflammatory signs The treatment of amyloid arthropathy could improve the quality of life of patients with multiple myeloma.
日本肩関節学会の論文

Amyloid shoulder padsの1例

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