title: Chameleon-like appearance of immunotactoid keratopathy.
abstract: OBJECTIVE
  To demonstrate 5 different patterns of immunotactoid keratopathy (ITK) in monoclonal gammopathy of undetermined significance (MGUS) that can mimic hereditary and degenerative disorders. First follow-up of 1 female patient was performed.
  
  
  METHODS
  Colored slit-lamp photodocumentation of 6 MGUS light kappa patients with different types of ITK, one patient with a follow-up of 7 years. Systemic and serological examinations of all 6 patients were performed.
  
  
  RESULTS
  The systemic and serological examinations disclosed an MGUS light kappa in all 6 patients. The 7-year follow-up of case 2 showed a reduction of lattice-like opacity to moderate diffuse corneal opacity. Corneal opacity patterns of the 6 patients were as follows: pattern 1, crystalline-like; pattern 2, lattice-like; pattern 3, peripheral granular-like; pattern 4, peripheral band-like; and patterns 5 and 6, peripheral patch-like.
  
  
  CONCLUSIONS
  ITK of MGUS can mimic cystinosis, Schnyder corneal dystrophy (CD), pre-Descemet CD, lattice CD, granular CD, arcus lipoides, lecithin-cholesterol acyltransferase deficiency, gelatinous drop-like CD, and Salzmann nodular degeneration. ITK can be the first symptom of MGUS. An annual internal check of MGUS is recommended because of occurrence of a systemic monoclonal gammopathy in 20% of cases.
authors.affiliation: prof.dr.lisch@augenklinik-hanau.de
authors.forename: Walter
authors.initials: W
authors.lastname: Lisch
authors.forename: Parykshit
authors.initials: P
authors.lastname: Saikia
authors.forename: Susanne
authors.initials: S
authors.lastname: Pitz
authors.forename: Uwe
authors.initials: U
authors.lastname: Pleyer
authors.forename: Christina
authors.initials: C
authors.lastname: Lisch
authors.forename: Melanie
authors.initials: M
authors.lastname: Jaeger
authors.forename: Jens M
authors.initials: JM
authors.lastname: Rohrbach
mesh_terms: D000368:Aged; D003318:Corneal Opacity / Q000209:etiology / Q000473:pathology*; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D006801:Humans; D007145:Immunoglobulin kappa-Chains; D008297:Male; D008875:Middle Aged; D010265:Paraproteinemias / Q000150:complications*; D010781:Photography / Q000379:methods
chemical_list: D007145:Immunoglobulin kappa-Chains