Unusual manifestations of type II cryoglobulinaemia associated with Waldenstrom's macroglobulinaemia

Cryoglobulinaemia in association with Waldenstrom's macroglobulinaemia is r elatively common, ranging from 8% to 18% of cases; however, < 5% have sympt oms or complications. We describe a patient with a history of cutaneous, pe ritoneal, and fallopian tube vasculitis related to type HI cryoglobulinaemi a associated with Waldenstrom's macro-globulinaemia. Cytotoxic treatment wa s initiated (cyclophosphamide, vincristine, and prednisone) and had a good initial response. However, after the third course of chemotherapy, the pati ent presented with septic shock and died. Even though cryoglobulinaemia is a model of systemic vasculitis, peritoneal and fallopian tube vasculitis as sociated with type II cryoglobulinemia has not been described previously.