Cryoimmunoglobulin IgGk with microtubular ultrastructure associated with pyoderma gangrenosum

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Abstract
Recurrent [human] gangrenous leg ulcers were associated with a monoclonal IgG.kappa. [immunoglobulin G.kappa.] cryoglobulinemia, though without overt myeloma. Cryoprecipitation of the serum (in vitro) gave a reversible gel with microtubular structure. The gel was built from the monomer and had a high degree of order. The same structure distended the superficial vessels of the ulcer biopsy. It was also found extravascularly. There was no vasculitis, and luminal obstruction appeared responsible for the ulceration. Microtubular structures occur in nature among diverse proteins and viruses. The protein studied here is similar to a reported instance of myeloma cryo-IgG.kappa.