IgA型多发性骨髓瘤继发重度混合型高脂血症一例及文献复习

 目的　探讨IgA型多发性骨髓瘤（MM）并发高脂血症的发生机制、临床特点及治疗方法。方法　报道IgA型MM患者伴发重度混合型高脂血症1例并进行文献复习。结果　单克隆IgA可通过竞争性与低密度脂蛋白（LDL）结合干扰LDL与LDL受体的结合，使胆固醇在血液循环中聚集，导致多继发性高脂血症。针对MM进行治疗使单克隆IgA浓度下降，血脂水平可平行下降。结论　严重高脂血症可加重MM的高黏症状，引起复杂临床情况。故在临床工作中应关注IgA型MM患者的血脂情况.

IgA type multiple myeloma associated with severe mixed type hyperlipidemia: one case report and literature review

Objective　To investigate the pathophysiology, clinical characteristics and therapeutics of IgA type multiple myeloma(MM) associated with severe mixed type hyperlipidemia. Methods　A case of multiple myeloma with sever hyperlipidemia was reported and literatures were reviewed. Results　There was a competitive binding between monoclonal IgA with blood serum low-density lipoprotein(LDL) to LDL reports, that interfered the binding of LDL to LDL receptors, and the cholesterol accumulated, hyperlipidemia oc－curred. Treatment of multiple myeloma reduced gradually the concentration of monoclonal IgA. Total choles－terol and triglycerides levels were reduced parallel. Conclusion　The hyperviscous in myeloma was aggravat－ed by severe hyperlipidemia, so the blood serum lipoprotein lever should be paid close attention in the man－agement of IgA type multiple myeloma.