Published date: Dec 31 2022

Journal Title: Sudan Journal of Medical Sciences

Issue title: Sudan JMS: Volume 17 (2022), Issue No. 4

Pages: 556–564

DOI: 10.18502/sjms.v17i4.12553

Abubaker A Mohamedsharifabubakerabdalgafar@gmail.com Faculty of Medicine, University of Khartoum, Khartoum, Sudan

Dalya M. M. AbdelmagedMD, Faculty of Medicine, Al Neelain University, Khartoum, Sudan

Carol A. Avila Universidad de Carabobo, Valencia, Venezuela

Michelle A. RiveraWeill Cornell Medicine, USA Weill Cornell Medicine, USA

A 53-year-old female presented with itchiness in her back. She has a 5 years history of tightness of the skin on her face, neck, and torso bilaterally. She did not have other symptoms suggestive of systemic sclerosis (scleroderma), and her rheumatologic workup was negative. Skin biopsy showed increased dermal mucin confirming a diagnosis of scleredema. Further workup with serum protein electrophoresis (SPEP) showed an M-spike, confirming the diagnosis of monoclonal gammopathy of undetermined significance MGUS as the underlying pathology.

Keywords: serum protein electrophoresis (SPEP), monoclonal gammopathy of undetermined significance (MGUS), double-stranded DNA (dsDNA), antibodies immunoglobulin G (ANA IgG), anti-Sjogren’s syndrome (SSB), antitopoisomerase antibody-type (SCL), ribonucleic acid (RNA), cyclic citrullinated peptide (CCP), U1 small nuclear ribonucleoprotein particle (U1 RNP), multiple myeloma (MM), immunomodulatory drugs (IMiDs), proteasome inhibitors (PIs), intravenous immunoglobulins (IVIG)

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