veoexrmpzt
Dołączył: 21 Lut 2011
Posty: 371
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Skąd: England
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 Wysłany: Pią 21:04, 04 Mar 2011 Temat postu: adidas scarpe ujc xwl hino jog |
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Special clinical report of four cases of multiple myeloma
, Post-rapid progression of the disease, multiple metastases of peritoneal, pleural,[link widoczny dla zalogowanych], abdominal lymph nodes, liver infiltration, clinical it is see. The ultrasound showed liver damage cases, amyloidosis consider relevant. 2.1.4 impairment of renal function: This Example 3,[link widoczny dla zalogowanych], Example 4 are the first manifestation of renal dysfunction. Kidney damage is a common lj} MM made Rush, clinical manifestations may have proteinuria, renal function is not so, kidney comprehensive {I_E, acute renal failure, chronic renal failure 5 types, and more common in chronic renal failure. MM mechanism may lead to renal damage in feet: ① direct infiltration of myeloma cells. Renal cortex to produce excessive free light chain. This light chain of glomerular filtrate in the proximal tubule was re-absorption, the degradation in the lysosomal toxicity, renal tubular damage from the bow l; ② proximal tubular free light chain than the maximum absorption rate, to reach the remote. Tubules, the small tube in the concentrated acid solution L. j common form of urinary protein tube this week, blocking the remote. Tubular; ③ myeloma cells to secrete a large number of molecules of osteoclast activation, leading to limitations of bone resorption, promote calcium into the blood, causing hypercalcemia; ④ MM patients with a nuclease, metabolism, hyperuricemia was increased; ⑤ myeloma cells of the globulin, can contribute to red blood cell aggregation, plasma outflow, blood concentration to form Hyperviscosity. Almost all patients had anemia, kidney damage but not parallel. Example 3 simultaneously infected, the infection is due to the lack of plasma cells produce abnormal immune activity of monoclonal immunoglobulin,[link widoczny dla zalogowanych], a decrease in the normal immune globulin, and the infection is often caused or aggravated an important cause of kidney failure. 2.2 Diagnosis of experience as the proliferation of myeloma cells in different extent and scope of infiltration, abnormal monoclonal immunoglobulin synthesis and secretion of many different,[link widoczny dla zalogowanych], leading to more complex clinical manifestations of this disease, easily missed diagnosis and misdiagnosis. But as long as the alert to seize the main points, timely and relevant examination, early diagnosis of MM is still feasible. Clinical work, the following conditions should be alert to the possibility of MM: ① bones and other parts of the mass; ② difficult to control long-term recurrent infection; ③ bleeding symptoms but normal platelet count; ④ unexplained anemia, especially the degree of anemia does not match their newly diagnosed disease; ⑤ erythrocyte sedimentation rate was significantly faster; ⑥ unexplained proteinuria, bone pain and cardiac symptoms. Doubt on the basis of the aforementioned, should be repeated multiple sites of bone marrow biopsy and bone marrow biopsy,[link widoczny dla zalogowanych], bone marrow biopsy sections to earlier and more accurately show the distribution of tumor cells in bone marrow and cell types. Peripheral blood smear, bone marrow smears should be to observe whether the mature red blood money was cord-like, in particular, observe the credits. Supplemented by whole body bone x ray and MRI examination Um, early diagnosis of MM is more conducive.
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