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Crystalglobulinemia manifested as acute renal failure and thrombotic vasculopathy

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Abstract

Crystalglobulinemia is an extremely rare pathology that is associated in most cases with plasma cell dyscrasia, mainly multiple myeloma. In most cases, it may be the manifestation of incipient gammopathy or it manifests shortly after diagnosis. We report a patient with ischemic lesions of thrombotic origin in lower limbs. Subsequently, renal involvement occurs, in view of this involvement, it is suspected that the patient may have an associated vasculitis. After performing the biopsy and with the subsequent diagnosis of monoclonal gammopathy of uncertain significance, the diagnosis is made. We review the most recent bibliography of patients who have been diagnosed with crystalglobulinemia associated with plasma dyscrasia focusing in those with thrombotic vasculopathy or acute renal failure. In our case, in addition to being associated with monoclonal gammopathy of undetermined significance that is less frequent, the debut of the symptoms is years before the detection of the monoclonal peak. This could speak of patients with a low peak of monoclonal component (not detected by immunoelectrophoresis) who could have kidney and vascular damage.

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Acknowledgements

E. Aristoy Gómez-Lechón (Hospital Universitario La Fe, Valencia, Spain) for English editing.

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Authors and Affiliations

  1. Department of Rheumatology, University Hospital of Salamanca, Salamanca, Spain

    L. Gómez-Lechón Quirós, M. E. Acosta De La Vega, O. Compán Fernández, S. Pastor Navarro, C. Montilla Morales & C. Hidalgo Calleja

  2. Department of Dermatology, University Hospital of Salamanca, Salamanca, Spain

    D. Moyano Bueno & A. Santos-Briz Terrón

  3. Department of Nephrology, University Hospital of Salamanca, Salamanca, Spain

    J. Martín Centellas

  4. Department of Pathological Anatomy, University Hospital of Salamanca, Salamanca, Spain

    A. Santos-Briz Terrón

  5. Complejo Asistencial Universitario de Salamanca, Salamanca, Spain

    L. Gómez-Lechón Quirós, M. E. Acosta De La Vega, O. Compán Fernández, S. Pastor Navarro, C. Montilla Morales, D. Moyano Bueno, J. Martín Centellas, A. Santos-Briz Terrón & C. Hidalgo Calleja

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  1. L. Gómez-Lechón Quirós
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  2. M. E. Acosta De La Vega
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  9. C. Hidalgo Calleja
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Contributions

All the authors have participated in the bibliographic search and preparation of the following manuscript. LGLQ: bibliographic search, case acquisition and writing—original draft, MEAV: bibliographic search and writing, OCF: bibliographic search and writing, SPN: bibliographic search, CAMM: editing, supervision, review, DMB: editing and imaging, JMC: editing and writing, ASBT: editing and imaging, CHC: bibliographic search, review and editing.

Corresponding author

Correspondence to L. Gómez-Lechón Quirós.

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Conflict of interest

We declare that this manuscript is original, has not been published before and is not currently being considered for publication elsewhere. We know no conflicts of interest associated with this publication, and there has been no financial support for this work that could have influenced its outcome. As Corresponding Author, I confirm that the manuscript has been read and approved for submission by all the named authors with subsequent modifications. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work. The publication is approved following the guidelines of the ethical committee of the University Hospital of Salamanca.

Ethical statement

The patient involved agrees to include her clinical data for the publication of the case report. All mandatory laboratory health and safety procedures have been complied with the course of conducting any experimental work reported in the manuscript.

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Gómez-Lechón Quirós, L., Acosta De La Vega, M.E., Compán Fernández, O. et al. Crystalglobulinemia manifested as acute renal failure and thrombotic vasculopathy. Rheumatol Int 40, 1327–1332 (2020). https://doi.org/10.1007/s00296-020-04620-6

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