CASE REPORTS   

Panminerva Medica 2002 June;44(2):149-50

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

A case of Sweet’s syndrome associated with monoclonal immunoglobulin of IgG-lambada type and p-ANCA positivity

Nocente R., Cammarota G. *, Gentiloni Silveri N. *, Rotoli M. **, Zannoni G. F. ***, Bertazzoni G., Ceccanti M. ****, Gasbarrini G. *

From the Emergency Department and ****Institute of Sixth Medical Clinic, Rome University “La Sapienza”, Rome, Italy *Department of Internal Medicine **Department of Dermatology ***Department of Pathology Catholic University of Rome, Rome, Italy

We ­report a ­case of Sweet’s syn­drome asso­ciat­ed ­with mono­clo­nal gam­mop­a­thy of uncer­tain sig­nif­i­cance (­MGUS) and pos­i­tiv­ity for per­i­nu­cle­ar anti­neu­troph­il cytop­las­mic anti­bod­ies (p-­ANCA). A 65-­year-old man ­patient ­came to our hos­pi­tal com­plain­ing of remit­tent-inter­mit­tent ­fever, ­weight ­loss, asso­ciat­ed ­with ­papules affect­ing all his ­body and with­out muco­sal or ocu­lar involve­ment. Histology of biop­sy spec­i­mens of ­papules ­allowed the diag­no­sis of Sweet’s syn­drome. This is the ­first ­case of ­this ­rare syn­drome asso­ciat­ed ­both ­with ­MGUS and p-­ANCA pos­i­tiv­ity. The mono­clo­nal immu­no­glob­u­lin, pos­sibly direct­ed to neu­troph­ils ­like an anti­body, may ­cause ­both ­their frag­men­ta­tion and ­release of anti­gens respon­sible of p-­ANCA appear­ance.