CRYSTALGLOBULIN-INDUCED VASCULOPATHY ACCOMPANYING ISCHEMIC INTESTINALLESIONS OF A PATIENT WITH MYELOMA

A 37 year old man with multiple myeloma (IgG lambda) developed perfora tion of the small intestine and had gangrene in his feet. In the resec ted small intestine and below-knee amputated feet, intravascular depos ition of crystals, immunohistochemically positive for IgG and a lambda light chain, were found. Although paraproteins produced in the course of plasma cell dyscrasia may crystallize and cause systemic occlusive vasculopathy, this is the first case with intestinal involvement. Bec ause cryoglobulinemia was absent in this patient, crystals may be deri ved from the myeloma protein which sometimes crystallizes in the blood without the influence of low temperature.