Effective measurement of coronary flow velocity reserve (CFVR) with transthoracic Doppler echocardiography (TTDE) for plasma cell leukemia with hyperviscosity syndrome

• OKA Satoko

  First Department of Internal Medicine, Osaka Medical College

• YOKOTE Taiji

  First Department of Internal Medicine, Osaka Medical College

• AKIOKA Toshikazu

  First Department of Internal Medicine, Osaka Medical College

• HARA Satoshi

  First Department of Internal Medicine, Osaka Medical College

• YAMANO Takeshi

  First Department of Internal Medicine, Osaka Medical College

• OKABE Taichi

  First Department of Internal Medicine, Osaka Medical College

• ARISHIRO Kumiko

  First Department of Internal Medicine, Osaka Medical College

• HOSHIGA Masaaki

  First Department of Internal Medicine, Osaka Medical College

• SHIMIZU Akira

  Central Clinical Laboratory, Osaka Medical College

• TSUJI Motomu

  Division of Surgical Pathology, Osaka Medical College

• HANAFUSA Toshiaki

  First Department of Internal Medicine, Osaka Medical College

Bibliographic Information

Other Title

• 過粘稠度症候群による冠血流不全に経胸壁的ドップラー超音波法が有用であった形質細胞性白血病
• 症例報告 過粘稠度症候群による冠血流不全に経胸壁的ドップラー超音波法が有用であった形質細胞性白血病
• ショウレイ ホウコク カネンチュウド ショウコウグン ニ ヨル カン ケツリュウ フゼン ニ ケイ キョウヘキテキ ドップラー チョウオンパホウ ガ ユウヨウ デ アッタ ケイシツ サイボウセイ ハッケツビョウ

Abstract

A 67-year-old woman was admitted with impaired general performance, suffering from fatigue, chest oppression on exertion, and paresthesia of the finger trips. The laboratory findings showed increased white blood cells with abnormal cells, and serum immunofixation test showed monoclonal IgMκ paraprotein. On flow cytometric immunophenotyping with CD38 gating, most of the abnormal cells expressed surface CD20, CD138, cytoplasmic IgM, but neither surface CD56 nor surface IgM. Immunohistochemical staining of abnormal cells was positive for surface CD38, surface CD20 and cytoplasmic IgM. The final diagnosis was plasma cell leukemia IgMκ type. Electrocardiography (ECG) on admission showed ST depression in II, III, aV_F, V4, V5, and V6. Coronary angiography (CAG) is invasive and difficult for patients with renal failure, therefore the patient underwent transthoracic Doppler echocardiography (TTDE), which revealed reduced coronary flow velocity reserve (CFVR). Two courses of VAD therapy were administered, then the condition improved, the serum IgM level decreased, abnormal cells were decreased in peripheral blood and bone marrow aspirates, and the creatinine levels improved. With the return of normal ECG findings and improved CFVR, the abnormal ECG and reduction in CFVR was thought to be associated with the hyperviscosity syndrome in PCL. Noninvasive assessment of CFVR by TTDE is significantly useful for the patients who have renal failure and need chemotherapy.

Journal

• Rinsho Ketsueki

  Rinsho Ketsueki 47 (1), 16-22, 2006

  The Japanese Society of Hematology

Keywords

• Plasma cell leukemia (PCL)
• Hyperviscosity syndrome
• Renal failure
• Transthoracic Doppler echocardiography (TTDE)
• Coronary flow velocity reserve (CFVR)

Details

• CRID: 1390282680008132224
• NII Article ID: 130004501023
• NII Article ID: 10017241704
• NII Book ID: AN00252940
• DOI: 10.11406/rinketsu.47.16
• COI: 1:STN:280:DC%2BD28%2FptlOqtg%3D%3D
• ISSN: 18820824
• ISSN: 04851439
• NDL BIB ID: 7811865
• PubMed: 16479978
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I7811865
• Web Site: https://search.jamas.or.jp/link/ui/2006118334
• Text Lang: ja
• Data Source:
  • JaLC
  • NDL
  • PubMed
  • CiNii Articles
• Abstract License Flag: Disallowed