Vortex keratopathy in a patient with multiple myeloma.
OBJECTIVE
We report a 52-year-old woman with vortex keratopathy (cornea verticillata) of unknown cause in whom multiple myeloma was found 18 months later.


METHODS
Surgical biopsy of conjunctival crystalline deposits, which were stained immunohistologically and analyzed ultrastructurally, as well as hematologic workup for multiple myeloma, were performed.


RESULTS
Light microscopy of conjunctival deposits revealed plasmacytoid infiltrates in the conjunctiva, which stained monoclonally for immunoglobulin G (IgG)-kappa light chains. Transmission electron microscopy showed intracellular hexagonal crystalline structures and extracellular microfibrils. Hematologic tests confirmed the diagnosis of multiple myeloma.


CONCLUSIONS
Multiple myeloma is one of the many causes of vortex keratopathy.
Chong
E M
EM
Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota 53905, USA.
Campbell
R J
RJ
Bourne
W M
WM
D000970:Antineoplastic Agents / Q000627:therapeutic use; D001706:Biopsy; D003228:Conjunctiva / Q000378:metabolism / Q000648:ultrastructure; D003315:Cornea / Q000378:metabolism / Q000473:pathology*; D003316:Corneal Diseases / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007074:Immunoglobulin G / Q000378:metabolism; D007145:Immunoglobulin kappa-Chains / Q000378:metabolism; D008854:Microscopy, Electron; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D014792:Visual Acuity
D000970:Antineoplastic Agents; D007074:Immunoglobulin G; D007145:Immunoglobulin kappa-Chains