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本文报告—46岁女性IgG型多发性骨髓瘤患者,合并严重粘膜出血,血小板数正常。经KPTT及其纠正试验证实为Ⅺ因子缺乏。患者无家族病史,经治疗后出血停止,KPTT恢复正常,故考虑为获得性Ⅺ因子缺乏。骨髓瘤合并Ⅺ因子缺乏的机转,可能与免疫球蛋白及血粘稠度增加有关。本例治疗前IgG、血粘稠均明显增加,治疗后二者均恢复正常,出血停止,Ⅺ因子亦恢复正常,似支持此种学说。
This article reports a 46-year-old female IgG-type multiple myeloma with severe mucosal hemorrhage and normal platelet count. The KPTT and its corrective test confirmed that the lack of factor Ⅺ. No history of family history of patients, bleeding stopped after treatment, KPTT returned to normal, it is considered to obtain sexual Ⅺ factor deficiency. The pathogenesis of myeloma complicated with factor Ⅺ deficiency may be related to the increase of immunoglobulin and blood viscosity. In this case before treatment, IgG, blood viscosity were significantly increased after treatment, both returned to normal, bleeding stopped, Ⅺ factors also returned to normal, it seems to support this theory.