Coexistence of diabetes mellitus and Waldenstrom macroglobulinebia: One case report
10.3760/cma.j.issn.1000-6699.2019.09.012
- VernacularTitle: 糖尿病合并华氏巨球蛋白血症一例报告
- Author:
Fangyuan CHEN
1
;
Yueyue WU
;
Xinmei HUANG
;
Zhiyan YU
;
Rui ZHANG
;
Fang WANG
;
Tiange SUN
;
Heyuan DING
;
Jun LIU
Author Information
1. Department of Endocrinology, Shanghai Fifth People′s Hospital Affiliated to Fudan University, Shanghai 200240, China
- Publication Type:Case Reports
- Keywords:
Diabetes mellitus;
Waldenstrom macroglobulinebia;
Immune globulin
- From:
Chinese Journal of Endocrinology and Metabolism
2019;35(9):789-791
- CountryChina
- Language:Chinese
-
Abstract:
This paper reports a case of a male patient with diabetes for more than 20 years who came to see doctor due to weakness, poor appetite and significantly elevated blood glucose. At first, it was considered that the poor blood glucose control of diabetes was the reason, and the possibility of diabetes related complications already existed. Hospital routine examination indicated a globulin increase and immunologic examination indicated that IgM was mainly increased. Subsequent imageological diagnosis revealed a small amount of bilateral pleural effusion, and after 2 weeks of hypoglycemic treatment, the blood glucose was significantly improved, but the symptoms still existed. In combination with the patient′s laboratory examination, considering the combination of blood system diseases, the hematology department was invited for consultation. Immunoelectrophoresis, bone marrow cytology, and flow cytometry were further conducted, and the patient was diagnosed with Waldenstrom macroglobulinebia. Bortezomib + dexamethasone regimen was given for chemotherapy. Currently, the patient has received 1 course of chemotherapy, and the symptoms of poor appetite were significantly improved. Coexistence of diabetes mellitus and Waldenstrom macroglobulinebia is very rare in clinical practice, and it is easy to be misdiagnosed as a complication of diabetes mellitus, both of which can be manifested as poor appetite, weakness, peripheral neuropathy and other symptoms. When diabetic patients have abnormal immunoglobulin increases and other abnormal test results that cannot be well explained by diabetes, other potential disorders, such as hematological diseases, should be considered to avoid missed diagnosis.
