A rare complication of multiple myeloma involves a vasculopathy associated with crystalline light chain deposits.


Features of the crystaloglobulinemia syndrome (CS):

(1) The patient has multiple myeloma.

(2) The patient may present with polyarthralgias and/or cutaneous ulcers.

(3) The patient develops a vasculopathy with ischemic injury to intestines, kidneys, digits, limbs and other organs.

(4) Crystals are seen at the sites of vascular injury.


Analysis of the crystal deposits shows monoclonal proteins including IgG and/or light chains.


Differential diagnosis:

(1) cryoglobulinemia or other cryoproteins

(2) other causes of vasculitis or vasculopathy

(3) essential crystalglobulinemia in the absence of multiple myelomas


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