Leukocytoclastic vasculitis associated with immunoglobulin A lambda monoclonal gammopathy of undetermined significance: A case report and review of previously reported cases

J Dermatol. 2018 Aug;45(8):1009-1012. doi: 10.1111/1346-8138.14466. Epub 2018 May 15.

Abstract

Leukocytoclastic vasculitis is often associated with immunoglobulin (Ig)A deposition on the vascular walls. IgA-associated leukocytoclastic vasculitis comprises various underlying diseases. Hematological disorders that can be minor triggers include multiple myeloma and monoclonal gammopathy of undetermined significance. Here, we present the case of a 78-year-old woman with leukocytoclastic vasculitis associated with monoclonal gammopathy of undetermined significance of the IgA lambda chain. Oral steroid administration initially showed remission of vasculitis; however, the condition recurred after four attempts of treatment withdrawal. We also reviewed previous reports of 14 cases of IgA-associated leukocytoclastic vasculitis, of which 11 were associated with multiple myeloma and three with monoclonal gammopathy of undetermined significance.

Keywords: M-protein gammopathy; immunoglobulin A-associated vasculitis; leukocytoclastic vasculitis; monoclonal gammopathy of undetermined significance; myeloma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Biopsy
  • Cryoglobulins / analysis
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunoglobulin A / analysis
  • Immunoglobulin A / immunology*
  • Monoclonal Gammopathy of Undetermined Significance / diagnosis
  • Monoclonal Gammopathy of Undetermined Significance / drug therapy
  • Monoclonal Gammopathy of Undetermined Significance / immunology*
  • Monoclonal Gammopathy of Undetermined Significance / pathology
  • Skin / blood supply
  • Skin / pathology
  • Vasculitis, Leukocytoclastic, Cutaneous / diagnosis
  • Vasculitis, Leukocytoclastic, Cutaneous / drug therapy
  • Vasculitis, Leukocytoclastic, Cutaneous / immunology*
  • Vasculitis, Leukocytoclastic, Cutaneous / pathology

Substances

  • Cryoglobulins
  • Glucocorticoids
  • Immunoglobulin A