In 1943, Waldenström delineated a syndrome consisting of recurring petechial eruption of the lower half of the body and hyperglobulinemia persisting for many years, apparently harmlessly.1 Other authors have confirmed the existence and the benignancy of this syndrome, although its pathogenesis has remained obscure. Of the 19 reported cases known to us, some have been associated with one of a variety of chronic inflammatory diseases, while in other cases no significant concomitant disease was apparent.2-5
A possible relationship to multiple myeloma has been suggested by the presence in purpura hyperglobulinemica of similar serum protein abnormalities and, frequently, of marrow lymphocytosis and anemia. The case presently reported is the first in which this possible relationship has evidently materialized, and it serves to emphasize that purpura hyperglobulinemica, even of over 10 years' duration, is not always benign.
Report of Case
A white male hydraulic engineer, born in 1901, was first