A patient with hyperglobulinemic purpura of Waldenstrom and systemic lupus erythematosus is reported. The coexistence of these two conditions which share a number of common clinical and laboratory features is rare. Treatment of the patient with prednisone, colchicine and hydroxy chloroquine led to the improvement of the cutaneous vasculitis and a drop in ESR, serum gamma globulins and IgM and IgG rheumatoid factors. The features of nine other cases and the immunopathogenesis of the disease are reviewed.
Finder KA, McCullough ML, Dixon SL, Majka AJ, Jaremko W.Hypergammaglobulinemic purpura of Waldenstrom. J Am Acad Dermatol1990; 23: 669-76.
4.
Stimmler MM, Chen Dcp, Quismorio FP Jr, Colletti PM, Siegel MESingle photon emission computed tomography (SPECT) and magnetic resonance imaging of the brain in neuropsychiatric SLE. Arthritis Rheum1990; 33: S103.
5.
Cohen PL, Cheek RL, Hadler JA, Yount WJ, Eisenberg RAThe subclass distribution of human IgG rheumatoid factor. J Immunol1987; 139: 1466-71.
6.
Cook L., Agnello V.Tests for detection of rheumatoid factors. In: Manual of Clinical Immunology. Rose NR et al. (eds). American Society of Microbiologists, 1992: 762-5.
7.
Leonhardt T.Familial hypergammaglobulinemia and systemic lupus erythematosus. Lancet1957; 2: 1200-3.
8.
Zaharia L., Hill JM, Loeb E., MacLellan A., Khan A., Hill NOSystemic lupus erythematosus in twin sisters following ten years of hyperglobulinemic purpura (Waldenstrom). Acta Med Scand1976 ; 199: 429-32.
9.
Pena ASSystemic lupus erythematosus, Sjögren's syndrome and purpura in a patient with coeliac disease. Neth J Med1987; 31: 305-7.
10.
Lozada JA, Maldonado N., Sanchez J., Fernandez C., Cortes M.Benign hyperglobulinemic purpura of Waldenstrom: a report of seven patients and long-term follow up. Bol Asoc Med P Rico1988; 80: 455-9.
11.
Martini A., Ravelli A., Viola S. et al. Hypergammaglobulinemic purpura in childhood. Helv Paediat Acta1988; 43: 225-31.
12.
White Rhr.Henoch-Schonlein purpura. In Systemic Vasculitides. Churg A, Churg J (eds). New York: Igaku-Shoin, 1991: 203-18.
13.
Quismorio FP Jr, Blau RH, Akmal M., Koss M.Palpable leg purpura and renal failure in a 23-year-old man. West J Med1984; 140: 60-5.
14.
Perks WH, Green F., Gleeson MHA case of purpura hyperglobulinemic of Waldenstrom studied by skin immunofluorescence . Br J Dermatol1974; 91: 563-8.
15.
Ferreari HE , Pasarin G., Quesada R., Gould E.Benign hypergammaglobulinemic purpura of Waldenstrom associated with Sjögren's syndrome. Case report and review of immunologic aspects. Am J Med1986; 81: 734-40.
Clayton R., Feiwel M.Benign hyperglobulinemic purpura of Waldenstrom. Br J Dermatol1976; 95: 60-2.
18.
Sugai S., Shimizu S., Tachibana J. et al. Hypergammaglobulinemic purpura in patients with Sjögren's syndrome: a report of nine cases and a review of the Japanese literature. Jpn J Med1989; 28: 148-55.
19.
Cream JJ, Bryceson Adm, Ryder G.Disappearance of immunoglobulin and complement from Arthur reaction and its relevance to the studies of vasculitis in man. Br J Dermatol1971; 84: 106-11.
20.
Serino G., Pitingolo F., Granatieri C. et al. Hypergammaglobulinemic purpura of Waldenstrom: characterization of circulating immune complexes. Acta Haematol1983; 69: 152-7.
21.
Clark RA, Abraham GN, Kyle R. et al. Gammaglobulin complexes in rheumatoid arthritis and hypergammaglobulinemic purpura. J Rheumatol1974; 1: 54-60.
22.
Hewitt P., Davies H., Cohen H. et al. Therapy of Waldenstrom's benign hypergammaglobulinaemia by regular plasmapheresis. Acta Haematol1984; 71: 345-9.
