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April 1989

Multisystem Crystalline Deposits

Author Affiliations

The University of Michigan Medical School, Ann Arbor

Arch Dermatol. 1989;125(4):555-556. doi:10.1001/archderm.1989.01670160103022

REPORT OF A CASE  A 30-year-old white man presented with a 2-month history of three asymptomatic erythematous ulcerated nodules on his legs. A representative lesion on his left knee is shown in Fig 1.He had a 10-year history of recurrent renal calculi. A ureterolithotomy had been done 6 years before. One year later, a bypass catheter was inserted in the right ureter for high-grade obstruction also by renal calculi. He was subsequently found to have end-stage renal disease and began receiving dialysis. He later received a cadaveric renal transplant.More recently, he developed cardiac dysrhythmias and was found to have a third-degree heart block. A His bundle recording of the conduction system of the heart revealed an infra-His bundle heart block. An endocardial biopsy specimen of the right ventricle is shown in Fig 2. The ventricle was dilated and the ejection fraction of the ventricle was markedly reduced. A