- Gammopathy, less aggressive variant
Mechanism
- Circulating immune complexes that contain IgG or IgA rheumatoid factor
- May have underlying autoimmune connective tissue disorder (most likely Sjogren)
Clinical presentation
- Episodic showers of petechiae occurring on all parts of the body (lower extremities more often)
- Dorsum of feet intensely involved
- Aggravated by prolonged standing or walking
Labs
- Serum electrophoresis shows a broad based peak (IgG mostly but IgA may be seen, IgM low or normal)
- Up to 80% have (+) SSA/Ro Abs
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