Atypical corneal immunoglobulin deposition in a patient with dysproteinemia.
OBJECTIVE
The purpose of this study was to report an unusual pattern of immunoglobulin deposition in the corneas of a patient with dysproteinemia.


METHODS
Clinical examination, slit lamp examination, a deep lamellar corneal biopsy, and serum and aqueous protein electrophoresis were obtained.


RESULTS
Slit lamp evaluation revealed amorphous, cloud-like opacities in the midperiphery at the level of deep stroma and Descemet's membrane. Electron microscopy demonstrated deep lamellar extracellular deposits consistent with immunoglobin. The serum protein electrophoresis revealed a monoclonal IgG kappa band, but the aqueous electrophoresis showed no bands in the gamma region.


CONCLUSIONS
This case documents a rare pattern of immunoglobulin deposition in the corneas in a patient with gammopathy. Despite its deep corneal distribution, the analysis of the aqueous specimen suggests that the source of the immunoglobulin is through a route other than from the aqueous.
Matoba
Alice Y
AY
Cullen Eye Institute, Baylor College of Medicine, Department of Ophthalmology, Houston, TX 77030, USA. amatoba@bcm.edu
Chevez-Barrios
Patricia
P
Jones
Dan B
DB
D000368:Aged; D003318:Corneal Opacity / Q000175:diagnosis / Q000378:metabolism*; D003319:Corneal Stroma / Q000473:pathology*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000378:metabolism*; D007145:Immunoglobulin kappa-Chains / Q000097:blood; D016393:Lymphoma, B-Cell / Q000473:pathology; D010265:Paraproteinemias / Q000175:diagnosis / Q000378:metabolism*; D014792:Visual Acuity / Q000502:physiology
D007074:Immunoglobulin G; D007145:Immunoglobulin kappa-Chains