Abstract
A 65-year-old female was admitted to Kyoto Yosanoumi Hospital on 12th March, 1982. She complained of palpitation and general fatigue. Physical examination demonstrated anemia, hepatosplenomegaly and no lymphadenopathy. In peripheral blood the red blood cell count was 309×104/mm3. Hemoglobin was 7.3 g/dl. Hematocrit was 24.5%. The white blood cell count was 3300/mm3. The platelet count was 15.2×104/mm3. Bone marrow aspiration revealed that the frequencies of plasmacytoid cells was 18.4%. In laboratory findings total protein was 8.7 g/dl with γ-gl 33.5%. IgM was 8,320 mg/dl. Serum protein study revealed monoclonal gammopathy with IgM-κ type and positive Sia test. Incubation of serum at 56°C for 30 min. resulted in formation of opapue gelatinous materials. All these findings are compatible with the diagnosis of macroglobulinemia with pyroglobulin. But cryoglobulin was not demonstrated. Melphalan 4 mg/day and predonin 30 mg/day were effective in reducing IgM and nomalizing total protein.
