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Immunotactoid Microtubular Corneal Deposits in Bilateral Paraprotein Crystalline Keratopathy

Singh, Kamaljeet MBBS, MD

doi: 10.1097/ICO.0b013e318191449a
Case Report

Purpose: To report an ultrastructurally distinct form of paraprotein crystalline keratopathy.

Methods: Three corneas submitted from a single patient including one native cornea from each eye and a failed corneal graft from the right eye. Light microscopy, immunohistochemistry, immunofluorescence, and transmission electron microscopic examination were performed.

Results: The transmission electron microscopy showed “immunotactoid” extracellular microtubular deposits measuring >30 nm in diameter with a central lucent core.

Conclusions: Immunotactoid keratopathy is a distinct type of paraprotein crystalline keratopathy associated with a monocolonal immunoglobulin G kappa light chain (IgGk) protein. Larger case series are needed to determine the clinical significance of this entity.

Received for publication April 22, 2008; revision received September 24, 2008; accepted October 12, 2008.

Reprints: Kamaljeet Singh, MBBS, MD, Resident, Department of Pathology, Rhode Island Hospital and Miriam Hospital, 593 Eddy Street, APC12, Providence, RI 02903 (e-mail:

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