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                          "etal" => false
                          "autores" => array:3 [
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                            2 => "L&#46;V&#46; Avioli"
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                    ]
                  ]
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                        "tituloSerie" => "Arch Intern Med"
                        "fecha" => "1983"
                        "volumen" => "143"
                        "paginaInicial" => "2946"
                        "paginaFinal" => "2951"
                        "itemHostRev" => array:3 [
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous manifestations as initial presentation of Waldenstr&#246;m&#39;s macroglobulinemia"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            2 => "V&#46; Perronne"
                            3 => "N&#46; Fouchard"
                            4 => "S&#46; Michael"
                            5 => "E&#46; Launay-Russ"
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                        "tituloSerie" => "Eur J Dermatol"
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                        "numero" => "1"
                        "paginaInicial" => "90"
                        "paginaFinal" => "92"
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                        "tituloSerie" => "Blood"
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                        "paginaFinal" => "1459"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8123836"
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                      "titulo" => "Monoclonal gammopathies and associated skin disorders"
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                        "paginaFinal" => "535"
                        "link" => array:1 [
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                            5 => "T&#46; Castel"
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                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "1982"
                        "volumen" => "106"
                        "paginaInicial" => "217"
                        "paginaFinal" => "222"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6800395"
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                            3 => "R&#46; Valenzuela"
                            4 => "J&#46;K&#46; Weick"
                            5 => "J&#46;R&#46; Young"
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                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "1980"
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                        "paginaInicial" => "575"
                        "paginaFinal" => "577"
                        "link" => array:1 [
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6769394"
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                            2 => "J&#46; Whittaker"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Exp Dermatol"
                        "fecha" => "2003"
                        "volumen" => "28"
                        "paginaInicial" => "491"
                        "paginaFinal" => "492"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12950334"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Beitrag zur makroglobulin&#228;mie Waldenst&#246;m mit kutaner tumormanifestation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "W&#46; Baudach"
                            1 => "K&#46; Schulz"
                            2 => "E&#46; Moldenhauer"
                            3 => "K&#46; Tessmann"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Zschr Inn Med"
                        "fecha" => "1970"
                        "volumen" => "25"
                        "paginaInicial" => "604"
                        "paginaFinal" => "608"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous manifestations of Waldenstr&#246;m&#39;s macroglobulinemia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "T&#46; Green"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "1989"
                        "volumen" => "121"
                        "paginaInicial" => "55"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Skin lesions in Waldenstr&#246;m&#39;s macroglobulinemia&#58; characterization of the cellular infiltrate"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "V&#46; Bergrouth"
                            1 => "S&#46; Reitamo"
                            2 => "Y&#46;T&#46; Konttinen"
                            3 => "O&#46; Wegelius"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Med Scan"
                        "fecha" => "1981"
                        "volumen" => "209"
                        "paginaInicial" => "129"
                        "paginaFinal" => "131"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous Waldenstr&#246;m&#39;s macroglobulinemia&#58; a report of a case successfully treated with radiotherapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "I&#46;F&#46; Orengo"
                            1 => "A&#46;H&#46; Kettler"
                            2 => "S&#46; Bruce"
                            3 => "M&#46;L&#46; Levy"
                            4 => "T&#46; Rosen"
                            5 => "J&#46; Tschen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer"
                        "fecha" => "1987"
                        "volumen" => "60"
                        "paginaInicial" => "1341"
                        "paginaFinal" => "1345"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3113711"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Macular skin lesion and monoclonal lymphoplasmacytoid infiltrates&#58; occurrence in primary Waldenstr&#246;m&#39;s macroglobulinemia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "N&#46; Mozzanica"
                            1 => "A&#46;F&#46; Finzi"
                            2 => "G&#46; Faccetti"
                            3 => "M&#46;L&#46; Villa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "1984"
                        "volumen" => "120"
                        "paginaInicial" => "778"
                        "paginaFinal" => "781"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6426407"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Immunchemische untersuchung der paraproteinbildung im hauttumor"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "H&#46;G&#46; Meiers"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1055/s-0028-1110829"
                      "Revista" => array:6 [
                        "tituloSerie" => "Dtsch Med Wochenschr"
                        "fecha" => "1968"
                        "volumen" => "93"
                        "paginaInicial" => "1795"
                        "paginaFinal" => "1800"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4175143"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous Waldenstr&#246;m&#39;s macroglobulinaemia in transformation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Appenzeller"
                            1 => "C&#46;P&#46; Leith"
                            2 => "K&#46; Foucar"
                            3 => "A&#46;A&#46; Scott"
                            4 => "C&#46;F&#46; Bigler"
                            5 => "C&#46;T&#46; Thompson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Dermatopathol"
                        "fecha" => "1999"
                        "volumen" => "21"
                        "paginaInicial" => "151"
                        "paginaFinal" => "155"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10218675"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acquired immunobullous disease&#58; A cutaneous manifestation of IgM macroglobulinemia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46;J&#46; Whitataker"
                            1 => "B&#46;S&#46; Bhogal"
                            2 => "M&#46;M&#46; Black"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "1998"
                        "volumen" => "135"
                        "paginaInicial" => "283"
                        "paginaFinal" => "286"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8881675"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bullous pemphigoid due to a 19S monoclonal paraprotein in a patient with Waldenstr&#246;m&#39;s &#40;abstract&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "K&#46;D&#46; Wuepper"
                            1 => "D&#46;J&#46; Key"
                            2 => "P&#46;J&#46; Kane"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Clin Res"
                        "fecha" => "1978"
                        "volumen" => "26"
                        "paginaInicial" => "579A"
                        "itemHostRev" => array:3 [
                          "pii" => "S1474442209701395"
                          "estado" => "S300"
                          "issn" => "14744422"
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                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bullous dermatosis associated with dysglobulinemia &#40;two cases&#41;&#58; relationships with epidermolysis bullosa"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Gompel"
                            1 => "O&#46; Bletry"
                            2 => "Y&#46; de Prost"
                            3 => "J&#46; Wechsler"
                            4 => "B&#46; Wechsler"
                            5 => "P&#46; Lebon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Biomed Pharmacother"
                        "fecha" => "1982"
                        "volumen" => "36"
                        "paginaInicial" => "199"
                        "paginaFinal" => "203"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6762227"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A case of acquired autoimmune bullous disease associated with IgM macroglobulinaemia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "E&#46; Morita"
                            1 => "K&#46; Horiuchi"
                            2 => "S&#46; Yamamoto"
                            3 => "T&#46; Hashimoto"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Dermatol"
                        "fecha" => "1999"
                        "volumen" => "26"
                        "paginaInicial" => "671"
                        "paginaFinal" => "676"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10554434"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
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            19 => array:3 [
              "identificador" => "bib20"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Examination of cutaneous macroglobulinosis by immunoelectron microscopy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "D&#46; Lipsker"
                            1 => "B&#46; Cribier"
                            2 => "N&#46; Boehm"
                            3 => "E&#46; Heid"
                            4 => "E&#46; Grosshans"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "1996"
                        "volumen" => "135"
                        "paginaInicial" => "287"
                        "paginaFinal" => "291"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8881676"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Macroglobulinemia cutis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46;E&#46; Tichenor"
                            1 => "J&#46;M&#46; Rau"
                            2 => "F&#46;A&#46; Mantz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "1978"
                        "volumen" => "114"
                        "paginaInicial" => "280"
                        "paginaFinal" => "281"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/415666"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1552526007006176"
                          "estado" => "S300"
                          "issn" => "15525260"
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                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous macroglobulinosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "W&#46; Hanke"
                            1 => "W&#46;D&#46; Steck"
                            2 => "W&#46;F&#46; Bergfeld"
                            3 => "R&#46; Valenzuela"
                            4 => "J&#46;K&#46; Weick"
                            5 => "J&#46;R&#46; Young"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "1980"
                        "volumen" => "116"
                        "paginaInicial" => "575"
                        "paginaFinal" => "577"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6769394"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous macroglobulinosis&#58; a case report with unique ultrastructural findings"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "L&#46; Lowe"
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                            2 => "J&#46;C&#46; Huff"
                            3 => "P&#46;F&#46; Stanley"
                            4 => "L&#46;E&#46; Golitz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "1992"
                        "volumen" => "128"
                        "paginaInicial" => "377"
                        "paginaFinal" => "380"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1550371"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Waldenstr&#246;m&#39;s macroglobulinemia-induced bullous dermatosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "N&#46;Y&#46; West"
                            1 => "J&#46;E&#46; Fitzpatrick"
                            2 => "K&#46;M&#46; David-Bajar"
                            3 => "S&#46;D&#46; Bennion"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "1998"
                        "volumen" => "134"
                        "paginaInicial" => "1127"
                        "paginaFinal" => "1131"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9762027"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25&#46;"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Waldenstr&#246;m&#39;s macroglobulinemia with an IgM-k antiepidermal membrane zone antibody"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46;W&#46; Cobb"
                            1 => "N&#46; Domloge-Hultsch"
                            2 => "J&#46;N&#46; Frame"
                            3 => "K&#46;B&#46; Yancey"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "1992"
                        "volumen" => "128"
                        "paginaInicial" => "372"
                        "paginaFinal" => "376"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1550370"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Schnitzler&#39;s syndrome&#58; report a case with progression to Waldenstrom&#39;s macroglobulinemia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "B&#46; Welsh"
                            1 => "B&#46; Tate"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Australas J Dermatol"
                        "fecha" => "1999"
                        "volumen" => "40"
                        "paginaInicial" => "201"
                        "paginaFinal" => "203"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10570556"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Urticarial dermatosis associated with Waldenstr&#246;m&#39;s macroglobulinemia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46;M&#46; Pujol"
                            1 => "M&#46;A&#46; Barnadas"
                            2 => "S&#46; Brunet"
                            3 => "J&#46;M&#46; de Moragas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "1989"
                        "volumen" => "20"
                        "paginaInicial" => "855"
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Vol. 99. Issue 2.
Pages 138-144 (March 2008)
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Vol. 99. Issue 2.
Pages 138-144 (March 2008)
Case reports
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Waldenström Macroglobulinemia Associated With Cutaneous Lesions and Type I Cryoglobulinemia
Macroglobulinemia de Waldenström Asociada a Lesiones Cutáneas y Crioglobulinemia Tipo IA
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J. del Olmoa, A. Españaa,
Corresponding author
aespana@unav.es

Correspondence: Departamento de Dermatología, Clínica Universitaria de Navarra, Facultat de Medicina, Universidad de Navarra, Apartado 4209 31080 Pamplona, Navarra, Spain.
, M.A. Idoateb, C. Panizoc
a Departamento de Dermatología, Clínica Universitaria de Navarra,Facultad de Medicina, Universidad de Navarra, Pamplona, Navarra, Spain
b Departamento de Anatomía Patológica, Clínica Universitaria de Navarra,Facultad de Medicina, Universidad de Navarra, Pamplona, Navarra, Spain
c Departamento de Hematología, Clínica Universitaria de Navarra,Facultad de Medicina, Universidad de Navarra, Pamplona, Navarra, Spain
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Article information
Abstract

Waldenström macroglobulinemia is a blood dyscrasia characterized by monoclonal proliferation of B cells in the bone marrow, lymph nodes, and spleen. Patients with this disease show elevated serum levels and tissue deposition of monoclonal immunoglobulin (Ig) M produced by these aberrant cells. We present the case of a patient with Waldenström macroglobulinemia who suffered cutaneous lesions resulting from deposition of #k light chains of IgM and clinical manifestations secondary to associated type I cryoglobulinemia. We discuss the different pathological cutaneous processes caused by IgM in Waldenström macroglobulinemia.

Key words:
Waldenström macroglobulinemia
IgM antibodies
Resumen

La macroglobulinemia de Waldenström (MW) es una discrasia sanguínea caracterizada por la proliferación monoclonal de células linfoplasmocitarias en la médula ósea, ganglios linfáticos y bazo. Estos pacientes tienen niveles elevados en suero y depósito en tejidos de la inmunoglobulina (Ig) M, de tipo monoclonal, producida por estas células aberrantes. Presentamos el caso de un paciente afecto de MW, con lesiones cutáneas debidas al depósito de cadenas ligeras Kappa de IgM y con manifestaciones clínicas secundarias a la crioglobulinemia tipo I que el paciente tenía asociada. Discutimos los distintos proceso patológicos cutáneos provocados por la IgM en la MW.

Palabras clave:
macroglobulinemia de Waldenström
anticuerpos IgM
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References
[1.]
T.F. Deuel, P. Davis, L.V. Avioli.
Waldenström's macroglobulinemia.
Arch Intern Med, 143 (1983), pp. 2946-2951
[2.]
M. Abdallah-Lotf, C. Bourgeois-Droin, V. Perronne, N. Fouchard, S. Michael, E. Launay-Russ, et al.
Cutaneous manifestations as initial presentation of Waldenström's macroglobulinemia.
Eur J Dermatol, 13 (2003), pp. 90-92
[3.]
M.A. Dimopoulos, R. Alexanian.
Waldenström's macroglobulinemia.
Blood, 83 (1994), pp. 1452-1459
[4.]
M.S. Daoud, J.A. Lust, R.A. Kyle, M.R. Pittelkow.
Monoclonal gammopathies and associated skin disorders.
J Am Acad Dermatol, 40 (1999), pp. 507-535
[5.]
J.M. Mascaro, E. Monserrat, T. Estrach, E. Feliu, J. Ferrando, T. Castel, et al.
Specific cutaneous manifestations of Waldenström's macroglobulinemia: a report of two cases.
Br J Dermatol, 106 (1982), pp. 217-222
[6.]
C.W. Hanke, W.D. Steck, W.F. Bergfeld, R. Valenzuela, J.K. Weick, J.R. Young, et al.
Cutaneous macroglobulinosis.
Arch Dermatol, 116 (1980), pp. 575-577
[7.]
L.F. Libow, J.P. Mawhinney, G.T. Bassinger.
Cutaneous Waldenström's macroglobulinemia: report of a case and overview of the spectrum of cutaneous disease.
J Am Acad Dermatol, 45 (2001), pp. S202-S206
[8.]
I. Chan, E. Calonje, J. Whittaker.
Cutaneous Waldenström's macroglobulinemia.
Clin Exp Dermatol, 28 (2003), pp. 491-492
[9.]
W. Baudach, K. Schulz, E. Moldenhauer, K. Tessmann.
Beitrag zur makroglobulinämie Waldenstöm mit kutaner tumormanifestation.
Zschr Inn Med, 25 (1970), pp. 604-608
[10.]
T. Green.
Cutaneous manifestations of Waldenström's macroglobulinemia.
Br J Dermatol, 121 (1989), pp. 55
[11.]
V. Bergrouth, S. Reitamo, Y.T. Konttinen, O. Wegelius.
Skin lesions in Waldenström's macroglobulinemia: characterization of the cellular infiltrate.
Acta Med Scan, 209 (1981), pp. 129-131
[12.]
I.F. Orengo, A.H. Kettler, S. Bruce, M.L. Levy, T. Rosen, J. Tschen.
Cutaneous Waldenström's macroglobulinemia: a report of a case successfully treated with radiotherapy.
Cancer, 60 (1987), pp. 1341-1345
[13.]
N. Mozzanica, A.F. Finzi, G. Faccetti, M.L. Villa.
Macular skin lesion and monoclonal lymphoplasmacytoid infiltrates: occurrence in primary Waldenström's macroglobulinemia.
Arch Dermatol, 120 (1984), pp. 778-781
[14.]
H.G. Meiers.
Immunchemische untersuchung der paraproteinbildung im hauttumor.
Dtsch Med Wochenschr, 93 (1968), pp. 1795-1800
[15.]
P. Appenzeller, C.P. Leith, K. Foucar, A.A. Scott, C.F. Bigler, C.T. Thompson, et al.
Cutaneous Waldenström's macroglobulinaemia in transformation.
Am J Dermatopathol, 21 (1999), pp. 151-155
[16.]
S.J. Whitataker, B.S. Bhogal, M.M. Black.
Acquired immunobullous disease: A cutaneous manifestation of IgM macroglobulinemia.
Br J Dermatol, 135 (1998), pp. 283-286
[17.]
K.D. Wuepper, D.J. Key, P.J. Kane.
Bullous pemphigoid due to a 19S monoclonal paraprotein in a patient with Waldenström's (abstract).
Clin Res, 26 (1978), pp. 579A
[18.]
A. Gompel, O. Bletry, Y. de Prost, J. Wechsler, B. Wechsler, P. Lebon, et al.
Bullous dermatosis associated with dysglobulinemia (two cases): relationships with epidermolysis bullosa.
Biomed Pharmacother, 36 (1982), pp. 199-203
[19.]
E. Morita, K. Horiuchi, S. Yamamoto, T. Hashimoto.
A case of acquired autoimmune bullous disease associated with IgM macroglobulinaemia.
J Dermatol, 26 (1999), pp. 671-676
[20.]
D. Lipsker, B. Cribier, N. Boehm, E. Heid, E. Grosshans.
Examination of cutaneous macroglobulinosis by immunoelectron microscopy.
Br J Dermatol, 135 (1996), pp. 287-291
[21.]
R.E. Tichenor, J.M. Rau, F.A. Mantz.
Macroglobulinemia cutis.
Arch Dermatol, 114 (1978), pp. 280-281
[22.]
W. Hanke, W.D. Steck, W.F. Bergfeld, R. Valenzuela, J.K. Weick, J.R. Young, et al.
Cutaneous macroglobulinosis.
Arch Dermatol, 116 (1980), pp. 575-577
[23.]
L. Lowe, J.E. Fitzpatrick, J.C. Huff, P.F. Stanley, L.E. Golitz.
Cutaneous macroglobulinosis: a case report with unique ultrastructural findings.
Arch Dermatol, 128 (1992), pp. 377-380
[24.]
N.Y. West, J.E. Fitzpatrick, K.M. David-Bajar, S.D. Bennion.
Waldenström's macroglobulinemia-induced bullous dermatosis.
Arch Dermatol, 134 (1998), pp. 1127-1131
[25.]
M.W. Cobb, N. Domloge-Hultsch, J.N. Frame, K.B. Yancey.
Waldenström's macroglobulinemia with an IgM-k antiepidermal membrane zone antibody.
Arch Dermatol, 128 (1992), pp. 372-376
[26.]
B. Welsh, B. Tate.
Schnitzler's syndrome: report a case with progression to Waldenstrom's macroglobulinemia.
Australas J Dermatol, 40 (1999), pp. 201-203
[27.]
R.M. Pujol, M.A. Barnadas, S. Brunet, J.M. de Moragas.
Urticarial dermatosis associated with Waldenström's macroglobulinemia.
J Am Acad Dermatol, 20 (1989), pp. 855-857
[28.]
W. Baudach, K. Schulz, E. Moldenhauer, K. Tessmann.
Beitrag zur makroglobulinämie Waldenström mit kutaner tumormanifestation.
Zschr Inn Med, 25 (1970), pp. 604-608
[29.]
M. Goodenberger, W.W. Piette, D.E. Macfarlane, Z.B. Argenyi.
Xanthoma disseminatum and Waldenström's macroglobulinemia.
J Am Acad Dermatol, 23 (1990), pp. 1015-1018
[30.]
G.K. Perera, S. Devereux, G. Mufti, J. Salisbury, D. Creamer.
PNP with Waldenström's macroglobulinemia.
Clin Exp Dermatol, 30 (2005), pp. 27-29
Copyright © 2008. Academia Española de Dermatología y Venereología and Elsevier España, S.L.
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