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Criyoglobulinemic Vasculitis Secondary to Multiple Myeloma



Criyoglobulins are immunoglobulins that precipitate at low  temperatures  and dissolve at higher temperatures. The existence of cryoglobulins in serum is termed cryoglobulinaemia. Although, the patients  with  cryoglobulinaemia or cryoglobulinemic vasculitis, the consequence  of cryoglobulinaemia, have typical  symptoms related to  the presence of cryoglobulins, may patients with  cryoglobulinaemia remain asymptomatic. Criyoglobulinaemia  a systemic vasculitis  involving primarily small vessels, can be associated  with infections, lymphoproliferative malignancies or autoimmune diseases. Type 1  criyoglobulins  can be found  in patients with , lymphoproliferative disorders, such as  Waldernström  macroglobulinaemia  or multiple myelom, while mixt criyoglobulins are detected  in patients with autoimmune diseases, lymphoproliferative disorders or infections, most commonly hepatitis C virus. We present a 38-year-old  man with  criyoglobulinemic vasculitis  secondary to multiple myeloma. The patient was admitted to hospital with one year history of cutaneous purpura, aggrevated with cold, on his legs and ears accompanied by arthralgia. Skin biopsy revealed leukocytoclastic vasculitis. There was serum cryoglobulinaemia and serum immunofixation electropheresis showed a IgG kapa monoclonal gamapathy. Contrasted computed tomography evidenced osteolytic lesions on his 4th rip, biopsy of which demonstrated a plasmocytoma. The bone marrow biopsy yielded 90 % of kapa monoclonal plasma cells verifying the diagnosis of multiple myeloma.

15 Jun, 2016
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e-Published: 29 Jun, 2016


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