潰瘍性大腸炎と多発性骨髄腫の合併した1例

抄録

A 58-year-old female visited a hospital due to frequent diarrhea and underwent the barium-enema revealing nothing in 1992. In 1996 colonoscopy was done due to bloody stool and revealed the active stage of ulcerative colitis, total-colitis-type.
Administration of Salicylazosulfapyridine (SASP) and lactic acid bacillus decreased the frequency of diarrhea. In January 1997, the lumbago and the right ankle pain occurred. The monoclonal protein in the serum and abnormal accumulation of the ^99mTc in the bone scintigraphy were clues for multiple myeloma. An immunoelectrophoresis showed the monoclonal protein (IgG κ-type) . Bone marrow aspiration revealed normocellular bone marrow with plasma cell proloferation (10.8%) and consisted with multiple myeloma. The therapy with melphalan and predonisolone was effective to reduce the monoclonal protein peak.
Only 2 cases have been reported on ulcerative colitis complicated by multiple myeloma. Several reports show that the risk is significantly increased for leukemia, non-Hodgkin lymphoma, and Hodgkin lymphoma in ulcerative colitis although the relationship between ulcerative colitis and multiple myeloma is unclear. Recently the number of ulcerative colitis patients has been increased. More attention must be paid for both colorectal and extracolonic malignant disorders in ulcerative colitis.