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Corneal and conjunctival crystals in paraproteinemia

H E Grossniklaus1, R D Stulting, N L'Hernault

  • 1Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA.

Human Pathology
|November 1, 1990
PubMed

Insights

Bilateral corneal and conjunctival crystal deposition in a patient was linked to paraproteinemia. Conjunctival biopsy revealed immunoglobulin crystals, aiding diagnosis of this condition.

Area of Science:

  • Ophthalmology
  • Hematology
  • Pathology

Background:

  • Corneal and conjunctival crystal deposition can be a rare manifestation of systemic disease.
  • Paraproteinemia, characterized by abnormal proteins in the blood, can present with diverse clinical findings.

Observation:

  • A 64-year-old woman presented with bilateral corneal and conjunctival crystal deposition.
  • Histopathological examination of a conjunctival biopsy revealed intracytoplasmic immunoglobulin crystals within fibrocytes, macrophages, and endothelial cells.

Findings:

  • Serum protein electrophoresis confirmed elevated kappa and IgA light and heavy chains.
  • Immunoperoxidase staining of the conjunctival biopsy corroborated the presence of these immunoglobulin chains within the crystals.

Implications:

  • Conjunctival and corneal crystal deposition may serve as a diagnostic indicator for underlying paraproteinemia.
  • Conjunctival biopsy is a valuable tool for the histopathological diagnosis of immunoglobulin crystal deposition disease.

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