Analysis of Clinical Misdiagnosis of Multiple Myeloma Manifested as Multi-ple System Involvement

FAN Xuejie; LIU Han; YANG Xuenong; ZHANG Bei; WU Hua; HE Xingjuan

doi:10.3969/j.issn.1002-3429.2023.07.005

Abstract：Objective To investigate the clinical features,causes of misdiagnosis and preventive measures of multi-ple myeloma(MM).Methods The clinical data of 14 MM patients who had been misdiagnosed with multiple diseases from April 2020 to January 2022 were retrospectively analyzed.Results In this group,3 cases were initially diagnosed as pulmo-nary infection due to repeated fever,cough,elevated inflammatory indexes and chest X-ray examination results;3 cases were initially diagnosed as chronic nephritis due to anorexia,lumbago pain,anemia,proteinuria,increased nocturia,facial and lower limb edema and abnormal urine routine;2 cases were initially diagnosed as lumbar muscle strain and osteoporosis due to lumbago and lumbar X-ray examination results.Nutritional anemia was initially diagnosed in 2 cases due to long-term sallow face,fatigue,palpitation and decreased hemoglobin,and cervical spondylosis was initially diagnosed in 2 cases due to dizzi-ness,nausea,upper limb weakness and numbness and X-ray examination of the neck.The duration of misdiagnosis was 10 d-3 months.The symptoms of 14 cases were not significantly improved after treatment according to the newly diagnosed disease,and MM was confirmed by serum protein electrophoresis,immunofixation electrophoresis and bone marrow puncture cytology.All the 14 cases were treated with chemotherapy on the basis of complication treatment,and their condition was stable after 6 months of follow-up;none of them relapsed or died.Conclusion The early manifestations of MM are complex and varied,and the specificity of laboratory examination is not high.If the doctor lacks understanding of the disease,the diagnostic think-ing is limited,and the specific examination is not performed early,it is more likely to cause misdiagnosis.Clinicians should be vigilant when patients are suspected with this disease,and perform comprehensive analysis of the condition and timely spe-cific examination,in order to improve the diagnosis rate.