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Abstract：
Multiple myeloma commonly manifests with symptoms arising from the involvement of various organs, particularly the bone and kidneys. In this report, we detail the case of a 44-year-old man who was diagnosed with multiple myeloma associated with reduced bone density. He exhibited clinical findings of osteomalacia due to Fanconi syndrome (characterized clinically by bone pain and proximal weakness and biochemically by elevated serum alkaline phosphatase, hypophosphatemia, hypouricemia, and glucosuria). With phosphate replacement, there was a notable improvement in bone pain, osteomalacia, and bone mineral density. Nevertheless, the patient continued to experience renal wasting of phosphate, uric acid, and glucose despite achieving remission from multiple myeloma for nearly 2 years. Our case highlights several important clinical features of myeloma-associated Fanconi syndrome, including the need to recognize this complication to appropriately treat the underlying bone disease while avoiding osteoclast inhibitors and the long-term persistence of the proximal renal tubulopathy despite achieving remission from myeloma and correction of osteomalacia.
摘要：
多发性骨髓瘤通常表现为各种器官受累引起的症状，尤其是骨骼和肾脏.在这份报告中,我们详述了一例44岁的男性,他被诊断患有多发性骨髓瘤并伴有骨密度降低.他表现出由于Fanconi综合征引起的骨软化症的临床发现（临床特征是骨痛和近端无力，生化特征是血清碱性磷酸酶升高，低磷酸盐血症,低尿酸血症,和糖尿）。用磷酸盐替换，骨痛有了显著的改善,骨软化症,和骨矿物质密度。然而，患者继续经历肾脏的磷酸盐消耗，尿酸,尽管多发性骨髓瘤缓解了近2年，但葡萄糖和葡萄糖。我们的病例突出了骨髓瘤相关的范可尼综合征的几个重要临床特征，包括需要认识到这种并发症以适当治疗潜在的骨疾病，同时避免使用破骨细胞抑制剂，以及尽管骨髓瘤缓解和骨软化症矫正，但近端肾小管病变的长期持续存在。
