Three cases of purpura hyperglobulinemia are reported with emphasis on the patients' protein abnormalities. The serum protein electrophoresis in this syndrome is typified by a broad elevation of the γ-globulin portion of the pattern. The rheumatoid factor serologic test is usually positive in such cases. Ultracentrifugation revealed a 9S to 15S serum protein fraction in each of our cases. Immunoelectrophoresis and immunoglobulin quantitation disclosed increases in IgG primarily, with lesser elevations of IgA and IgM. Fluorescent antibody tracing studies showed mild to moderate intranuclear immunofluorescence in epidermal cells similar to that seen in systemic lupus erythematosus. Presently available evidence suggests that purpura hyperglobulinemia is in the collagen disease group and may be an auto-immune process.
CARR RD, HEISEL EB. Purpura Hyperglobulinemia. Arch Dermatol. 1966;94(5):536–541. doi:10.1001/archderm.1966.01600290010002
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