Hypergammaglobulinemic purpura of Waldenström-Unusual and impressive case in a patient with myeloma: A case report

Celina DeBiasio; Janelle Cyr; Stephanie Petkiewicz; Steven J Glassman

doi:10.1177/2050313X221086321

Hypergammaglobulinemic purpura of Waldenström-Unusual and impressive case in a patient with myeloma: A case report

SAGE Open Med Case Rep. 2022 Mar 22:10:2050313X221086321. doi: 10.1177/2050313X221086321. eCollection 2022.

Authors

Celina DeBiasio¹, Janelle Cyr², Stephanie Petkiewicz³, Steven J Glassman²

Affiliations

¹ Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
² Division of Dermatology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
³ Division of Anatomical Pathology, Department of Laboratory Medicine, University of Ottawa, Ottawa, ON, Canada.

Abstract

Background: Hypergammaglobulinemic purpura of Waldenström is an uncommon disease, which presents mostly in women on the lower extremities. It is sometimes associated with underlying immune dysregulation. Sjögren syndrome is the most common association; however, rare occurrences of the self-resolving syndrome with lymphoma or myeloma have been reported.

Case summary: We describe an unusual and impressive presentation of hypergammaglobulinemic purpura of Waldenström in an elderly female patient with myeloma. Notably, the patient did not have any concurrent connective tissue diseases. Despite her florid presentation, her hypergammaglobulinemic purpura of Waldenström spontaneously resolved within a few days.

Conclusion: Hypergammaglobulinemic purpura of Waldenström is a self-resolving but recurrent syndrome, which may be associated with autoimmune disorders or rarely myeloma. Early diagnosis of the syndrome may avoid unnecessary treatment interventions and should prompt screening for underlying diseases.

Keywords: Leukocytoclastic vasculitis; Waldenström; hypergammaglobulinemia; purpura.

Publication types

Case Reports