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Jeon: Cryoglobulinemia with a Digital Gangrene from Monoclonal Gammopathy of Undetermined Significance
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J Rheum Dis 2015;22(6):405-406.

Published online: 31 October 2015

DOI: https://doi.org/10.4078/jrd.2015.22.6.405

Cryoglobulinemia with a Digital Gangrene from Monoclonal Gammopathy of Undetermined Significance

Chan Hong Jeon

Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea

Corresponding to: Chan Hong Jeon, Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon 14584, Korea. E-mail: chjeon@gmail.com

Received 4 August 2015       Revised 19 August 2015       Revised 26 August 2015       Accepted 26 August 2015

Copyright © 2015 The Korean College of Rheumatology

This is a Free Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.

REFERENCES

1. Harel S, Mohr M, Jahn I, Aucouturier F, Galicier L, Asli B, et al. Clinico-biological characteristics and treatment of type I monoclonal cryoglobulinaemia: a study of 64 cases. Br J Haematol. 2015; 168:671–8.
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2. Dispenzieri A, Katzmann JA, Kyle RA, Larson DR, Melton LJ 3rd, Colby CL, et al. Prevalence and risk of progression of light-chain monoclonal gammopathy of undetermined significance: a retrospective population-based cohort study. Lancet. 2010; 375:1721–8.
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3. Terrier B, Karras A, Kahn JE, Le Guenno G, Marie I, Benar-ous L, et al. The spectrum of type I cryoglobulinemia vasculitis: new insights based on 64 cases. Medicine (Baltimore). 2013; 92:61–8.
4. Kyle RA, Buadi F, Rajkumar SV. Management of monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM). Oncology (Wil-liston Park). 2011; 25:578–86.

Figure 1.
There was gangrene of the left second toe. Other toes also showed mild cyanotic change on their tips with a background of livedo reticularis.
jrd-22-405f1.tif
Figure 2.
On peripheral blood smear, after incubation in room temperature, extracellular pale pink amorphous materials were observed (Wright-Giemsa stain, ×200).
jrd-22-405f2.tif
Figure 3.
A bone marrow biopsy showed a normal myeloid to erythroid ratio and the usual maturation pattern but multifocal aggregates of plasma cells were observed (Wright-Giemsa stain, ×400).
jrd-22-405f3.tif
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