title: Crystalglobulinemia with fulminant course with cylinder-like bodies on peripheral blood smear.
abstract: A 63-year-old woman presented to our hospital with fever, purpura and pain in both legs and died 4 days after admission. Her blood smear and skin biopsy showed cylinder-like bodies (20×120 μm). She was diagnosed to have monoclonal gammopathy (IgG, lambda type). An autopsy revealed cylinder-like bodies in the vasculature of various organs. We noted a proliferation of atypical plasma cells in her bone marrow, suggesting pre-existing myeloma. Crystalglobulinemia is a rare manifestation of hypergammaglobulinemia that can cause multiple embolisms of the small vessels, and this resulted in the patient's fulminant course. The identification of cylinder-like bodies in the peripheral blood may help in reaching a diagnosis in such cases.
authors.affiliation: Department of Rheumatology, Infectious Diseases, and Laboratory Medicine, Faculty of Medicine, University of Miyazaki, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kawaguchi
authors.forename: Yumi
authors.initials: Y
authors.lastname: Kariya
authors.forename: Motohiro
authors.initials: M
authors.lastname: Matsuda
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Kubo
authors.forename: Syunichi
authors.initials: S
authors.lastname: Miyauchi
authors.forename: Norio
authors.initials: N
authors.lastname: Kusumoto
authors.forename: Shiro
authors.initials: S
authors.lastname: Ueno
authors.forename: Ichiro
authors.initials: I
authors.lastname: Takajo
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Nagatomo
authors.forename: Yuki
authors.initials: Y
authors.lastname: Tahira
authors.forename: Syoko
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Kenji
authors.initials: K
authors.lastname: Yorita
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kataoka
authors.forename: Akihiko
authors.initials: A
authors.lastname: Okayama
mesh_terms: D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology; D003460:Crystallization; D017809:Fatal Outcome; D005260:Female; D006403:Hematologic Tests; D006801:Humans; D006942:Hypergammaglobulinemia / Q000097:blood* / Q000473:pathology*; D007146:Immunoglobulin lambda-Chains / Q000097:blood*; D009101:Multiple Myeloma / Q000150:complications / Q000473:pathology; D010950:Plasma Cells / Q000473:pathology; D012867:Skin / Q000098:blood supply / Q000473:pathology
chemical_list: D007146:Immunoglobulin lambda-Chains