[Cryoglobulinemic vasculitis due to hyperviscosity and cryogel formation as the onset of multiple myeloma. Report of one case]

Rev Med Chil. 2022 Jun;150(6):832-835. doi: 10.4067/S0034-98872022000600832.
[Article in Spanish]

Abstract

Multiple Myeloma (MM) is characterized by a clonal expansion of plasma cells in the bone marrow. These cells typically produce a monoclonal immunoglobulin, and its symptoms arise either from plasma cell infiltration in several organs, or secondary to the presence of a monoclonal protein peak. Symptoms can be summarized by the acronym CRAB (hypercalcemia, renal failure, anemia and bone lesions). Sometimes, in the setting of a protein secreting monoclonal gammopathy, formation of cryoglobulins develops. Cryoglobulins are plasma proteins that precipitate at low temperatures, forming a cold - induced precipitate at small vessels, causing a wide range of clinical manifestations. We report a female consulting for ulcers lasting 2 months in the left foot associated with purpuric lesions in both lower limbs. Protein electrophoresis showed a monoclonal peak in the gamma region. Bone marrow aspirate showed 27% of plasma cells with kappa chain restriction by cytometry. The presence of cryoglobulins was confirmed. The patient was treated with dexamethasone and bortezomib, with a progressive healing of lower limb lesions and disappearance of cryoglobulins. She was discharged in good conditions.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Bortezomib / therapeutic use
  • Cryogels
  • Cryoglobulinemia* / complications
  • Cryoglobulinemia* / diagnosis
  • Cryoglobulins / metabolism
  • Female
  • Humans
  • Multiple Myeloma* / complications
  • Multiple Myeloma* / diagnosis
  • Vasculitis* / complications

Substances

  • Cryogels
  • Cryoglobulins
  • Bortezomib