ABSTRACT
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.
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