, Volume 89, Issue 8, pp 823-824
Date: 15 Dec 2009

Monoclonal gammopathy of undetermined significance related pyoderma gangrenosum successfully treated with autologous peripheral blood stem cell transplantation

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Dear Editor,

We report a patient of monoclonal gammopathy of undetermined significance (MGUS) with manifestation of pyoderma gangrenosum refractory to steroids and chemotherapy. Both the M-protein and pyoderma gangrenosum disappeared after autologous peripheral blood stem cell transplantation (PBSCT).

A 33-year-old man suffered from rapidly enlarging pustular papules and plagues that ulcerated the necrotic base over his left leg 5 years ago (Fig. 1a). His serum immunoelectrophoresis revealed IgA-λ monoclonal gammopathy (IgA 782 mg/dL, normal 70–400 mg/dL; κ/λ 1.17, normal 1.35–2.69). Bone marrow examination disclosed slight plasmacytosis, which was less than 10% of all the nucleated cells (Fig. 1b). Without anemia (hemoglobin, 12.7 mg/dl; normal, 12–14 mg/dl), thrombocytopenia (platelet count, 426 × 109/l; normal, 150–430 × 109/l), osteolytic lesions, and impaired renal function, he was diagnosed as MGUS, IgA-λ, complicated with pyoderma gangrenosum. Fig. 1

ac Pyoderma gangrenosum. Large ...