Cryoglobulinaemic vasculitis associated with multiple myeloma

Cryoglobulins are single or mixed immunoglobulins that reversibly precipitate at low temperatures. The clinical manifestations of cryoglobulinemia vary based on cryoglobulin type. Type I cryoglobulins are associated with plasma cell dyscrasias and lymphoproliferative disorders, and may result in vaso-occlusive phenomena and hyper-viscosity syndrome due to high levels of circulating monoclonal cryoglobulin, leading to physical obstruction of vessels. We describe a case of cryoglobulinemic vasculitis associated with multiple myeloma, complicated by hyper-viscosity syndrome.