以腹泻为主的华氏巨球蛋白血症1例并文献复习

目的 提高临床医生对华氏巨球蛋白血症消化道受累的认识。方法 报告1例慢性腹泻伴体质量减轻最终诊断为华氏巨球蛋白血症病例，回顾文献讨论该病累及消化道的特点。结果 报告1例华氏巨球蛋白血症明显胃肠道受累的病例，表现为慢性腹泻伴体质量减轻和低蛋白血症。小肠活检淀粉样变阴性。患者接受利妥昔单抗联合苯达莫司汀治疗腹泻很快缓解。检索文献回顾性分析华氏巨球蛋白血症与消化道症状的关联。结论 提高对华氏巨球蛋白血症胃肠道表现的认识可能有助于解释和治疗这种惰性、潜在危及生命的淋巴系统恶性疾病。

Diarrhea as the principal presentation of Waldenström macroglobulinemia: a case report and literature review

Objective To enhance clinicians understanding of the involvement of gastrointestinal tract in Waldenström macroglobulinemia(WM). Methods A case of chronic diarrhea with weight loss diagnosed as WM was reported. Relevant literature was reviewed. Results The WM case was associated with significant gastrointestinal involvement, manifested as chronic diarrhea with weight loss and hypoproteinemia. Small bowel biopsy was negative for amyloidosis. Rituximab in combination with bendamustine soon relieved the diarrhea. Literature about the association of WM with gastrointestinal symptoms was reviewed. Conclusion An increased awareness of the gastrointestinal manifestations of WM may help to explain and treat the indolent, potentially life-threatening lymphatic malignancy.