The occurrence of a severe medium-vessel vasculitis in association with Type 1 cryoglobulinemia is rare. Even after a decade of monoclonal gammopathy, paraproteinemia and cryoglobulinemia may contribute to medium-size arteritis and gangrene.
A 50-year-old man with a monoclonal gammopathy of undetermined significance (MGUS) of 10 years’ duration developed mild bilateral foot paresthesias. One year later, he presented with crescendo, incapacitating right foot pain. Intense livedo reticularis and dry …