摘要：

A 69-year-old woman was admitted to our Hospital on December 2004 for evaluation of peripheral edema and bilateral purpura on lower legs. There were no systemic symptoms except for mild asthenia. She had had a past history of disseminated hydatidosis with liver, kidney and bone involvement. On physical examination, hyperpig-mented areas of 2-4 mm in diameter consistent with purpura and peripheral edema were observed in lower legs. Cardiopulmonary, otolaryngology and neurological examinations were normal. Initial laboratory tests revealed: serum total protein 5.3 g/dl (normal range, 6.4-8.3 g/dl), albumin 2.8 g/dl (normal range, 3.8-5.1 g/dl), LDH 344UI/1 (normal range, 150-450 UI/l), creatinine 0.86 mg/dl (normal range, 0.6-1.4 mg/dl), hemoglobin 87 g/l, white cell count 6.2 X 10~9 L~(-1), platelets 703 x 10~9 L~(-1). Complement levels were under normal value: C3 126 mg/dl (normal range, 79-180mg/dl), C4 <10mg/dl (normal range, 10-40mg/dl) and irnmunoserological analyses were normal. Serum immu-noelectrophoresis on specific antisera revealed expression of cryoglobulin identified as monoclonal IgM-kappa. Moreover, proteinuria in the range of nephrotic syndrome could be demonstrated in urine analysis. Peripheral blood smears and bone marrow examination were unremarkable. Antibodies for HCV, HBV and HIV types 1 and 2 were negatives and serologies for hydatidosis showed low antigen levels (antigen title < 1/320; antibody negative).

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