• Jingjing Wen, Fang Xu, Min Li, Qiaoling Zhou, Wen Qu, Yiping Liu, Jing Su, and Hong Hu.
• Hematology Department.
• Medicine (Baltimore). 2019 Jul 1; 98 (28): e16382e16382.

RationaleType I monoclonal cryoglobulinemia is usually associated with lymphoproliferative disorders, such as monoclonal gammopathy of undetermined significance (MGUS), myeloma, chronic lymphocytic leukemia (CLL) and lymphoplasmocytic lymphoma (LPL). Clinical symptoms related to Type I cryoglobulin (CG) isotype often include skin, neurological and renal manifestations.Patient ConcernsA 42-year-old woman who initially presented urticaria, palpable purpura in both her upper extremities and legs, eosinophilia and Raynaud phenomenon. Skin biopsy revealed eosinophil infiltration. Monoclonal immunoglobulin (Ig) G-κprotein was detected and CG was also positive.DiagnosesThe patient was finally diagnosed as MGUS related Type I CG.InterventionsCyclophosphamide-dexamethasone-thalidomide (CDT) therapy was initiated.OutcomesThe treatment relieved the skin symptoms efficiently.LessonsTo our knowledge, this is a rare case of Type I cryoglobulinemic vasulitis with eosinophilia complicated by MGUS, and the effective treatment of cyclophosphamide combined with thalidomide and prednisone may provide a new therapeutic option for cryoglobulinemic vasulitis.

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