{"created":"2023-06-19T10:29:32.719522+00:00","id":1653,"links":{},"metadata":{"_buckets":{"deposit":"0a6a05af-16be-460b-bd44-afff349df7c9"},"_deposit":{"created_by":31,"id":"1653","owners":[31],"pid":{"revision_id":0,"type":"depid","value":"1653"},"status":"published"},"_oai":{"id":"oai:kwmed.repo.nii.ac.jp:00001653","sets":["1709617079800:35:321:559"]},"author_link":["111161","111162","111163","111164","111165","111166","111167","111168","111169","111170","111171","111172","111173","111174","111175","111176","111177","111178","111179","111180"],"item_1694495855422":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_type":"VoR"}]},"item_3_biblio_info_12":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2014","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"48","bibliographicPageStart":"43","bibliographicVolumeNumber":"40","bibliographic_titles":[{"bibliographic_title":"川崎医学会誌","bibliographic_titleLang":"ja"},{"bibliographic_title":"Kawasaki medical journal","bibliographic_titleLang":"en"}]}]},"item_3_description_8":{"attribute_name":"記事種別(日)","attribute_value_mlt":[{"subitem_description":"症例報告","subitem_description_language":"ja","subitem_description_type":"Other"}]},"item_3_identifier_14":{"attribute_name":"URL","attribute_value_mlt":[{"subitem_identifier_type":"URI","subitem_identifier_uri":"http://igakkai.kms-igakkai.com/wp/wp-content/uploads/2014/KMJ-J40(1)43.pdf"}]},"item_3_relation_20":{"attribute_name":"DOI","attribute_value_mlt":[{"subitem_relation_type_id":{"subitem_relation_type_id_text":"https://doi.org/10.11482/KMJ-J40(1)43","subitem_relation_type_select":"DOI"}}]},"item_3_source_id_1":{"attribute_name":"雑誌書誌ID","attribute_value_mlt":[{"subitem_source_identifier":"AN00045593","subitem_source_identifier_type":"NCID"},{"subitem_source_identifier":"AN12940574","subitem_source_identifier_type":"NCID"}]},"item_3_source_id_19":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0386-5924","subitem_source_identifier_type":"PISSN"},{"subitem_source_identifier":"2758-089X","subitem_source_identifier_type":"EISSN"}]},"item_3_text_6":{"attribute_name":"著者所属(日)","attribute_value_mlt":[{"subitem_text_language":"ja","subitem_text_value":"医療法人清梁会高梁中央病院検査科"},{"subitem_text_language":"ja","subitem_text_value":"医療法人清梁会高梁中央病院検査科"},{"subitem_text_language":"ja","subitem_text_value":"医療法人清梁会高梁中央病院検査科"},{"subitem_text_language":"ja","subitem_text_value":"医療法人清梁会高梁中央病院内科"},{"subitem_text_language":"ja","subitem_text_value":"医療法人清梁会高梁中央病院内科"},{"subitem_text_language":"ja","subitem_text_value":"医療法人清梁会高梁中央病院内科"},{"subitem_text_language":"ja","subitem_text_value":"医療法人清梁会高梁中央病院内科"},{"subitem_text_language":"ja","subitem_text_value":"医療法人清梁会高梁中央病院内科"},{"subitem_text_language":"ja","subitem_text_value":"医療法人清梁会高梁中央病院内科"},{"subitem_text_language":"ja","subitem_text_value":"医療法人清梁会高梁中央病院血液内科,川崎医科大学名誉教授"}]},"item_3_text_7":{"attribute_name":"著者所属(英)","attribute_value_mlt":[{"subitem_text_language":"en","subitem_text_value":"Department of Medical Technology, Takahashi Central Hospital"},{"subitem_text_language":"en","subitem_text_value":"Department of Medical Technology, Takahashi Central Hospital"},{"subitem_text_language":"en","subitem_text_value":"Department of Medical Technology, Takahashi Central Hospital"},{"subitem_text_language":"en","subitem_text_value":"Department of Internal Medicine, Takahashi Central Hospital"},{"subitem_text_language":"en","subitem_text_value":"Department of Internal Medicine, Takahashi Central Hospital"},{"subitem_text_language":"en","subitem_text_value":"Department of Internal Medicine, Takahashi Central Hospital"},{"subitem_text_language":"en","subitem_text_value":"Department of Internal Medicine, Takahashi Central Hospital"},{"subitem_text_language":"en","subitem_text_value":"Department of Internal Medicine, Takahashi Central Hospital"},{"subitem_text_language":"en","subitem_text_value":"Department of Internal Medicine, Takahashi Central Hospital"},{"subitem_text_language":"en","subitem_text_value":"Division of Hematology, Takahashi Central Hospital. Kawasaki Medical School (Professor Emeritus)"}]},"item_3_textarea_10":{"attribute_name":"抄録(日)","attribute_value_mlt":[{"subitem_textarea_language":"ja","subitem_textarea_value":"広義の骨髄腫関連疾患には,古典的なmyelomaを始めとして,plasmacytic leukemia,plasmacytomaさらにmacroglobulinemia,lymphoplasmacytic lymphomaなどが含まれる.一般的には特徴的検査所見の一つに,血清総蛋白の高値がある.ところが,今回我々は血清総蛋白がむしろ低値であった骨髄腫関連疾患を経験した.症例は85歳女性.貧血軽度,黄疸(-),肝脾腫(-),リンパ節腫大(-),骨病変は軽微であった.検査所見:末梢血WBC4370/μl,RBC242万/μl,Hgb8.1g/dl,Hct25.6%,PLT6.2万/μl,Neut70.7%,Lym23.6%,Mono5.0%,Eos0.2%,Bas0.5%.生化学:TP5.3g/dl,Alb2.0g/dl,Glob3.3g/dlそのうちIgG532mg/dl,IgA79mg/dl,IgM2,035mg/dlで,免疫電気泳動にて明らかなM-bowを認め,IgM-_K型と判明した.骨髄:採取した標本では低形成で,Mgk10/μl,赤芽球15.6%,顆粒球系60.3%,リンパ球系23.8%,そのうち形質細胞1.9%であった.形態学的には,マクログロブリン血症の際にみられるリンパ・形質細胞様の所見であった.細胞表面マーカーの検索では,リンパ球全体ではCD7 33.5%,CD138 0.7%,CD19 7.0%,CD20 32.8%,形質細胞ではCD7 21.8%,CD138 57.7%,CD19 21.1%,CD20 39.7%であった.病理検査では,N/C比が高く異型性のある核を持つ細胞のシート状の集簇が認められた.腫瘍細胞の透過型電顕所見では,核は偏在し,大型のゴルジ野を有し,粗面小胞体はよく発達し,蛋白合成の盛んなことが推測された.細胞によっては,分化度が低く核クロマチンは繊細で明らかに芽球様の細胞も認められた.染色体分析:46,XX.末梢血生化学所見では総蛋白量の明らかな減少が認められたが,その病因は腫瘍細胞によるIgMの過剰産生にあり,その腫瘍性性質のため正常免疫グロブリン特にIgGおよびIgAの著しい産生抑制を生じたものと考えられる.細胞学的にはマクログロブリン血症と多発性骨髄腫とにまたがる境界領域に位置付けられるBリンパ球系悪性疾患と推定される."}]},"item_3_textarea_11":{"attribute_name":"抄録(英)","attribute_value_mlt":[{"subitem_textarea_language":"en","subitem_textarea_value":"It is known that myeloma-related disorders include classical myeloma, plasmacytic leukemia, plasmacytoma, macroglobulinemia, lymphoplasmacytic lymphoma and others. Increased serum protein is one of the characteristic features in these disorders. We have recently experienced a case of myeloma-related disorder with hypoproteinemia. The patient (a 85 year-old female) demonstrated hypoproteinemia (total protein 5.3g/dl, Alb2.0g/dl, Glob3.3g/dl) with increased IgM 2,035mg/dl contrary to decreased IgG(532mg/dl) and IgA(79mg/dl). The presence of IgM-_K monoclonality was detected by immunoelectrophoresis. Peripheral blood showed slight anemia(RBC 2.42×10^6/μl) and thrombocytopenia(62×10^3/μl). Peripheral lymphocytes were 23.6% with lymphoplasmacytic appearance. Bone marrow examination revealed that lymphocytes were 23.8% with 1.9% of plasma cells: CD79a(+), CD138(+/-), CD20(+/-), CD5(-), cyclin D1(-), IgM(+), IgA(-), IgG(+-), and IgM_K -monoclonality(+) by immune staining method. Surface makers of all lymphoid cells indicated CD138 57.7%, CD19 21.1%, and CD20 39.7%. Clusters of malignant lymphoid cells were present in bone marrow specimen. Transmission electron microscopy (TEM) on the lymphoid cells indicated the dislocated nucleus and profound rough-surfaced ribosomes with large Golgi apparatus suggesting the markedly enhanced protein production. In some cells, the blastic appearance with fine nuclear chromatin structure was observed. The pathogenesis of hypoproteinemia appears to be due to suppression of IgG and IgA by increased IgM monoclonality, in addition to decreased level of serum albumin. The disorder is considered to be localized at the border area between classical myeloma and macroglobulinemia."}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"秋庭, 早苗","creatorNameLang":"ja"},{"creatorName":"アキバ, サナエ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"三宅, 智子","creatorNameLang":"ja"},{"creatorName":"ミヤケ, トモコ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"米山, 美貴子","creatorNameLang":"ja"},{"creatorName":"コメヤマ, ミキコ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"戸田, 俊介","creatorNameLang":"ja"},{"creatorName":"トダ, シュンスケ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"中村, 隆資","creatorNameLang":"ja"},{"creatorName":"ナカムラ, タカシ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"志茂, 公洋","creatorNameLang":"ja"},{"creatorName":"シモ, キミヒロ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"來山, 浩之","creatorNameLang":"ja"},{"creatorName":"キタヤマ, ヒロユキ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"岩井, 隆行","creatorNameLang":"ja"},{"creatorName":"イワイ, タカユキ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"山崎, 浩子","creatorNameLang":"ja"},{"creatorName":"ヤマサキ, ヒロコ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"八幡, 義人","creatorNameLang":"ja"},{"creatorName":"ヤワタ, ヨシヒロ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Akiba, Sanae","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Miyake, Tomoko","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Komeyama, Mikiko","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Toda, Shunsuke","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Nakamura, Takashi","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Shimo, Kimihiro","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Kitayama, Hiroyuki","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Iwai, Takayuki","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Yamasaki, Hiroko","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Yawata, Yoshihito","creatorNameLang":"en"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2017-01-23"}],"displaytype":"detail","filename":"KJ00009303359.pdf","filesize":[{"value":"1.0 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"KJ00009303359.pdf","objectType":"fulltext","url":"https://kwmed.repo.nii.ac.jp/record/1653/files/KJ00009303359.pdf"},"version_id":"ac961d44-d2ee-43fb-8895-3163b03280df"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"骨髄腫","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"マクログロブリン血症","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"低蛋白血症","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"Myeloma","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Macroglobulinemia","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Hypoproteinemia","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"低蛋白血症で発見された骨髄腫関連疾患の一症例","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"低蛋白血症で発見された骨髄腫関連疾患の一症例","subitem_title_language":"ja"},{"subitem_title":"A case of myeloma-related disorder detected by hypoproteinemia","subitem_title_language":"en"}]},"item_type_id":"3","owner":"31","path":["559"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2017-01-23"},"publish_date":"2017-01-23","publish_status":"0","recid":"1653","relation_version_is_last":true,"title":["低蛋白血症で発見された骨髄腫関連疾患の一症例"],"weko_creator_id":"31","weko_shared_id":-1},"updated":"2023-10-11T02:41:00.325640+00:00"}