Corneal deposits as an alerting sign of monoclonal gammopathy: a case report.
OBJECTIVE
To report the clinical and histopathologic findings of the corneal deposits in a patient with monoclonal gammopathy.


METHODS
Amorphous corneal deposits developed bilaterally in a 55-year-old woman. The corneal button obtained during penetrating keratoplasty was analyzed histologically, immunohistochemically, and ultrastructurally.


RESULTS
The patient was diagnosed as having monoclonal gammopathy because of the elevation of serum immunoglobulin G (IgG) and kappa light chain. Histologic evaluation disclosed that the deposits were eosinophilic, periodic acid-Schiff positive, and stained red with Masson's trichrome. Immunohistochemical examination showed that these deposits reacted positively for IgG and the kappa light chain. Electron microscopy showed electron-dense deposits composed of parallel fine filaments with a periodicity of 10-13 nm.


CONCLUSIONS
We conclude from the immunohistochemical results that monoclonal gammopathy can lead to corneal deposits that are dense enough to decrease vision. Because monoclonal gammopathy may be a life-threatening disease and early diagnosis is important, ophthalmologists should be aware that corneal deposits can be an alerting sign of monoclonal gammopathy.
Kato
T
T
Department of Ophthalmology, Juntendo University, Tokyo, Japan. t-kato@pb3.so-net.ne.jp
Nakayasu
K
K
Omata
Y
Y
Watanabe
Y
Y
Kanai
A
A
D003315:Cornea / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D007122:Immunoelectrophoresis; D007074:Immunoglobulin G / Q000378:metabolism; D007145:Immunoglobulin kappa-Chains / Q000737:chemistry / Q000378:metabolism; D007150:Immunohistochemistry; D008854:Microscopy, Electron; D008875:Middle Aged; D010265:Paraproteinemias / Q000378:metabolism / Q000473:pathology*
D007074:Immunoglobulin G; D007145:Immunoglobulin kappa-Chains