多発性骨髄腫に合併した全身性アミロイドーシス

・多発性骨髄腫の経過中に上眼瞼に紫斑・丘疹が出現した．皮膚生検にて病理組織学的に真皮のアミロイド沈着を証明し，全身性アミロイドーシスと確定診断しえた症例．・ALアミロイドーシスの予後は一般的に不良であるが，紫斑や丘疹などの皮膚病変は早期に出現するため，これらが確認されてから死亡までは2年以上と報告されている．・眼瞼および舌などの好発部位を注意深く診察し皮膚病変を見出すことは，全身性アミロイドーシスの早期診断に非常に有用であると考える．（「症例のポイント」より）

A case of systemic amyloidosis with multiple myeloma Iga, Saki1）Yokoi, Kazunori1）Nishimoto, Tomoko1）Okawa, Taori1）Higashiyama, Mari1）Kawakami, Manabu2） 1）Department of Dermatology, Nippon Life Hospital 2）Department of Hematology, Nippon Life Hospital Abstract A 64-year-old female who had underwent lobectomy due to lung cancer. She was admitted to our hospital with arthralgia, edema and dyspnea. She was diagnosed as multiple myeloma and consulted us for amyloidosis. Purpura and papules were observed on the upper eyelids, tongue and around anus. The biopsy from purpura comfirmed diagnosis of AL amyloidosis. She died after several days due to heart failure of amyloidosis. In AL amyloidosis heart and kidney failure are the serious causes of death. Skin manifestations like purpura or papules have preceded them about two years. It’s important to find skin manifestations for early diagnosis in AL amyloidosis.