THE occurrence of hyperglobulinemia and purpura was first reported by Waldenström.1,2 The increased gamma globulin is of the 7S type and, unlike myeloma globulin, shows a broad base on paper electrophoresis. Numerous other cases, recently reviewed by Strauss,3 have since been reported. In some, an underlying disease such as sarcoid, lupus erythematosus and Sjögren's syndrome was present, but more often no underlying disease was found. The condition usually begins insidiously with occasional attacks of purpura on the distal lower extremities. Over several years the attacks usually become more frequent, and eventually the purpura may involve an entire lower extremity and, . . .