Journal article
Light Chain Myeloma Precipitating Cryoglobulinemic Vasculitis
Journal of community hospital internal medicine perspectives, Vol.13(1), pp.42-47
01/08/2023
DOI: 10.55729/2000-9666.1143
PMCID: PMC9924627
PMID: 36817297
Abstract
Multiple Myeloma (MM) is characterized by monoclonal immunoglobulin production leading to widespread skeletal destruction and renal dysfunction. Light chain multiple myeloma (LCMM) affects 15% of individuals with MM and has an overall poor prognosis. Cutaneous manifestations are uncommon and it is rarely complicated by Type I Cryoglobulinemia (CG). Here we present an atypical case of κ-predominant LCMM complicated by Type I CG in an 80-year-old man who presented with a progressive non-blanching necrotic rash and ulcers involving his face, distal extremities, and oropharynx of two months duration prior to his admission at our facility. On admission to our facility, workup showed an overabundance of κ-light chains, elevated free κ/λ ratio, cryoglobulins, and an acute kidney injury. Marrow biopsy demonstrated 60% plasma cells with κ-light chain predominance. Cutaneous manifestations such as acral cyanosis and distal gangrene in LCMM indicate late stages of the disease, and such findings should raise suspicion for additional comorbid pathologies, including cryoglobulinemia, which could help direct earlier initiation of treatment.
Details
- Title: Subtitle
- Light Chain Myeloma Precipitating Cryoglobulinemic Vasculitis
- Creators
- Bilal Saeed - MedStar HealthSamah A. Omar - Georgetown University Medical CenterRobert Jones - MedStar Franklin Square Medical CenterChristopher J. Haas - Georgetown University Medical Center
- Resource Type
- Journal article
- Publication Details
- Journal of community hospital internal medicine perspectives, Vol.13(1), pp.42-47
- Publisher
- Greater Baltimore Medical Center
- DOI
- 10.55729/2000-9666.1143
- PMID
- 36817297
- PMCID
- PMC9924627
- ISSN
- 2000-9666
- eISSN
- 2000-9666
- Language
- English
- Date published
- 01/08/2023
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984697054302771
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