临床误诊误治2025，Vol.38Issue(14)：15-19,5.DOI:10.3969/j.issn.1002-3429.2025.14.004
多发性骨髓瘤合并顽固性高钙血症延误诊治分析及文献复习
Delayed Diagnosis and Treatment of Multiple Myeloma Complicated with Refractory Hypercalcemia and Literature Review
毛雪涵 1莫峥 2李佼 1李利红 1张爱 3黄月华1
作者信息
- 1. 102218 北京,清华大学北京清华长庚医院血液内科
- 2. 102218 北京,清华大学北京清华长庚医院肿瘤内科
- 3. 100730 北京,中国医学科学院北京协和医院血液内科
- 折叠
摘要
Abstract
Objective To explore the causes and preventive measures of delayed diagnosis and treatment in patients with multiple myeloma complicated with refractory hypercalcemia.Methods The clinical data of a newly diagnosed multiple myeloma patient with refractory hypercalcemia in June 2021 who achieved disease remission after systemic therapy were retrospectively analyzed.Results A 73-year-old female patient was diagnosed with multiple myeloma due to anemia,foamy urine and hypercalcemia as initial manifestations,based on bone marrow puncture and other related examinations.Hypercalcemia was considered to be related to multiple myeloma.After receiving systemic anti-myeloma therapy,the patient's myeloma was in remission,but he still had persistent hypercalcemia.Further screening showed that the intact parathyroid hormone was significantly elevated and that a hypoechoic nodule was found below the lower pole of the right parathyroid lobe,so the patient was diagnosed with primary hyperparathyroidism.The diagnosis was delayed for 15 months.The family declined surgical treatment and the patient was given Zoledronic Acid/Denosumab to reduce blood calcium,resulting in a sustained stable state of the disease.Conclusion Although hypercalcemia is one of the common onset manifestations of multiple myeloma,in clinical practice,when we receive patients with unexplained hypercalcemia of primary disease,we need to make the corresponding differential diagnosis to avoid missing other possible combined diseases.关键词
多发性骨髓瘤/高钙血症/原发性甲状旁腺功能亢进/误诊/鉴别诊断Key words
Multiple myeloma/Hypercalcemia/Primary hyperparathyroidism/Misdiagnosis/Differential Diagnosis分类
医药卫生引用本文复制引用
毛雪涵,莫峥,李佼,李利红,张爱,黄月华..多发性骨髓瘤合并顽固性高钙血症延误诊治分析及文献复习[J].临床误诊误治,2025,38(14):15-19,5.
