Transl Clin Pharmacol.  2017 Sep;25(3):134-137. 10.12793/tcp.2017.25.3.134.

A case of Waldenström's macroglobulinemia treated using clarithromycin and prednisolone

• Ohe M
• Hashino S
• Shida H
• Horita T
• Sugiura M

• KMID: 2390932
• DOI: http://doi.org/10.12793/tcp.2017.25.3.134

Abstract

We report a case of Waldenström's macroglobulinemia (WM) treated using clarithromycin (CAM) and prednisolone (PSL). An 84-year-old woman was admitted to our hospital for bleeding after a tooth extraction and hematuria. Computed tomography showed multiple ill-defined nodules in the omentum (omental cake). Although the cause of the omental cake remained unclear, the patient was diagnosed with WM, based on the detection of M-protein of immunoglobulin (Ig) M in serum and lymphoplasmacytes in bone marrow. The bleeding tendency in the patient may have been due to acquired hemophilia and/or hyper IgM-induced platelet dysfunction. The patient was treated using CAM (800 mg/day) and PSL (10 mg/day). As a result, IgM levels gradually decreased. Because the omental cake contracted along with improvement in IgM, it was thought to be lymphoplasmacytic lymphoma-like lymphoma. This case shows that treatment using CAM and PSL may be effective in some cases of WM.

Keyword

Macroglobulinemia; Lymphoma; Clarithromycin; Prednisolone

MeSH Terms

Aged, 80 and over
Blood Platelets
Bone Marrow
Clarithromycin*
Female
Hematuria
Hemophilia A
Hemorrhage
Humans
Immunoglobulin M
Immunoglobulins
Lymphoma
Omentum
Prednisolone*
Tooth Extraction
Waldenstrom Macroglobulinemia*
Clarithromycin
Immunoglobulin M
Immunoglobulins
Prednisolone

Figure

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  Figure 1 A bone marrow aspiration smear showing lymphoplasmacytes.

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  Figure 2 (A) Contrast-enhanced computed tomography (CT) images showing para-aortic lymphadenopathy, multiple ill-defined nodules in the omentum (omental cake), an omental tumor accompanied by vessel augmentation, and ascites, (B) Contrast-enhanced CT images showing the omental cake, the omental tumor, and ascites.

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  Figure 3 (A) CT images showing the improvement in the omental cake, the omental tumor, para-aortic lymphadenopathy, and ascites, (B) CT images showing the improvement in the omental cake, the omental tumor, and ascites.

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