Waldenstrom's macroglobulinaemia presenting as reticulate purpura and bullae in a patient with hepatitis B virus infection

Citation
S. Cho et al., Waldenstrom's macroglobulinaemia presenting as reticulate purpura and bullae in a patient with hepatitis B virus infection, CLIN EXP D, 26(6), 2001, pp. 513-517
Citations number
13
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Dermatology
Journal title
CLINICAL AND EXPERIMENTAL DERMATOLOGY
ISSN journal
0307-6938 → ACNP
Volume
26
Issue
6
Year of publication
2001
Pages
513 - 517
Database
ISI
SICI code
0307-6938(200109)26:6<513:WMPARP>2.0.ZU;2-8
Abstract
Cutaneous manifestations of Waldenstrom's macroglobulinaemia (WM) include p urpura, ulcers, urticaria, leukocytoclastic vasculitis, and immunobullous d ermatoses. No association has been reported previously of WM and hepatitis B virus (HBV) infection. A 40-year-old female HBV carrier was admitted to h ospital because of generalized oedema, oliguria, haematuria, hypertension, fever and blood-tinged sputum. Cutaneous manifestations included generalize d petechiae, palpable purpura mainly on the legs, multiple necrotic ulcerat ions and gangrenous changes on the toes, and necrotic, giant confluent reti culate purpura on the trunk surmounted by several tense bullae. Laboratory investigations revealed monoclonal gammopathy of IgM kappa type (6.7 g/L), membranoproliferative glomerulonephritis associated with HBV infection, Ben ce Jones proteinuria, and an increased number of abnormal plasmacytoid cell s in the bone marrow Pathologic examination demonstrated immune complex-med iated vasculitis with deposits of IgM in the walls of dermal vessels and se condary subepidermal bulla formation. HBV infection may have caused WM or m odified the clinical course in this fatal case.