Sheeza Basharat
Sheeza Basharatabout 1 year ago
Diagnose It

Diagnose It

A 58-year-old man presented with a petechial and purpuric rash limited to the lower extremities. He reported that the rash had been present for months but worsened acutely over the last 3 days with new-onset dark urine, joint pain, and edema limiting his ability to walk. Physical examination showed areas of violaceous macules and papules on the legs and dorsal feet in a reticular distribution. Laboratory findings were remarkable for an elevated serum creatinine level of 2.75 mg/dL (reference range, 0.70–1.30 mg/dL), and serum immunofixation revealed the presence of markedly elevated IgG lambda monoclonal proteins. He was afebrile and his vital signs were stable. Dermatology, nephrology, and rheumatology services were consulted.⁠ ⁠ What's your diagnosis?⁠ A. angioinvasive fungal infection⁠ B. antiphospholipid antibody syndrome⁠ C. calciphylaxis⁠ D. livedoid vasculopathy⁠ E. type I cryoglobulinemia

Top rated comment
about 1 year ago

type 1 cryglobenemia likely

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