{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T00:27:43Z","timestamp":1718843263390},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T00:00:00Z","timestamp":1718755200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T00:00:00Z","timestamp":1718755200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Ophthalmol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Paraproteinemic keratopathy is a rare disorder characterized by the bilateral accumulation of polychromatic deposits diffusely in all corneal layers together or not with diffuse or patchy pseudo lipid deposits. We present an atypical case of paraproteinemic keratopathy which lead to an initial misdiagnosis of infectious crystalline keratopathy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>a 69-year-old woman with an asymptomatic keratopathy detected during a cataract intervention. Slit-lamp examination revealed several hyper refringent subepithelial foci with fern-shaped branches, resembling crystalline keratopathy, in her left eye. Anterior segment optical coherence tomography revealed exclusively subepithelial hyperreflective lesions limited to the anterior stroma. The progressive bilateralization and progression of the condition prompted us to include other entities with crystalline corneal deposits in our differential diagnosis. Hematological analysis showed a high number of free Kappa light chains. Despite the typical clinical appearance of crystalline keratopathy, the atypical evolution and test results led us to consider that monoclonal gammopathy could be the cause of this entity.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Paraproteinemic keratopathy may present in its early stages as a unilateral subepithelial crystalline keratopathy. Thus, it must always be taken into account in the differential diagnosis of any crystalline keratopathy, particularly when there are no predisposing factors for an infectious crystalline keratopathy. Early recognition of this rare entity is important to address the associated potentially serious systemic disease.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12886-024-03487-6","type":"journal-article","created":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T10:04:14Z","timestamp":1718791454000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Paraproteinaemic keratopathy simulating a crystalline keratopathy"],"prefix":"10.1186","volume":"24","author":[{"given":"Andrea","family":"Aramburu-Gonz\u00e1lez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"L\u00f3pez-Plandolit Antolin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose Antonio","family":"M\u00e1rquez-Navarro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,6,19]]},"reference":[{"issue":"7","key":"3487_CR1","doi-asserted-by":"publisher","first-page":"987","DOI":"10.1111\/aos.14123","volume":"97","author":"P Skalicka","year":"2019","unstructured":"Skalicka P, Dudakova L, Palos M, Huna LJ, Evans CJ, Mahelkova G, et al. Paraproteinemic keratopathy associated with monoclonal gammopathy of undetermined significance (MGUS): clinical findings in twelve patients including recurrence after keratoplasty. Acta Ophthalmol. 2019;97(7):987\u201392.","journal-title":"Acta Ophthalmol"},{"issue":"7","key":"3487_CR2","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1016\/j.jfo.2019.04.002","volume":"42","author":"A Fouquart","year":"2019","unstructured":"Fouquart A, Sukno M, Rouland J-F. Crystalline keratopathy. J Fr Ophtalmol. 2019;42(7):803\u20134.","journal-title":"J Fr Ophtalmol"},{"issue":"2","key":"3487_CR3","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1016\/S0002-9394(00)00712-1","volume":"131","author":"MS Sridhar","year":"2001","unstructured":"Sridhar MS, Sharma S, Garg P, Rao GN. Epithelial infectious crystalline keratopathy. Am J Ophthalmol. 2001;131(2):255\u20137.","journal-title":"Am J Ophthalmol"},{"issue":"4","key":"3487_CR4","doi-asserted-by":"publisher","first-page":"480","DOI":"10.1016\/j.survophthal.2017.10.008","volume":"63","author":"AJ Porter","year":"2018","unstructured":"Porter AJ, Lee GA, Jun AS. Infectious crystalline keratopathy. Surv Ophthalmol. 2018;63(4):480\u201399.","journal-title":"Surv Ophthalmol"},{"issue":"4","key":"3487_CR5","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1016\/j.sjopt.2019.01.002","volume":"33","author":"JL Romero-Trevejo","year":"2019","unstructured":"Romero-Trevejo JL, Bosch-Gili R, Jim\u00e9nez-Rodr\u00edguez E, Gonz\u00e1lez de Gor-Crooke JL. Infectious crystalline keratopathy: management of three cases with different risk factors. Saudi J Ophthalmol. 2019;33(4):409\u201312.","journal-title":"Saudi J Ophthalmol"},{"key":"3487_CR6","doi-asserted-by":"publisher","first-page":"100803","DOI":"10.1016\/j.ajoc.2020.100803","volume":"19","author":"S Nobacht","year":"2020","unstructured":"Nobacht S, Kusters B, Breukink MB, Rongen GA, Cruysberg JRM. Recurrence of paraproteinemic crystalline keratopathy after corneal transplantation: a case of monoclonal gammopathy of ocular significance. Am J Ophthalmol Case Rep. 2020;19:100803.","journal-title":"Am J Ophthalmol Case Rep"},{"issue":"12","key":"3487_CR7","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1016\/j.oftal.2012.06.019","volume":"88","author":"JC Mesa-Guti\u00e9rrez","year":"2013","unstructured":"Mesa-Guti\u00e9rrez JC, Rouras-L\u00f3pez A, Am\u00edas-Lamana V, Hoyos-Chac\u00f3n J, Cabir\u00f3-Badim\u00f3n I, Porta-Monnet J. Crystalline keratopathy due to kappa chains in a monoclonal gammopathy. Arch Soc Esp Oftalmol. 2013;88(12):489\u201392.","journal-title":"Arch Soc Esp Oftalmol"},{"key":"3487_CR8","unstructured":"Moshirfar M, West W, Ronquillo Y. Paraproteinaemic keratopathy. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 [cited 2021 Oct 17]. http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK560482\/."},{"key":"3487_CR9","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1016\/j.ajoc.2018.12.010","volume":"13","author":"HC Stiefel","year":"2019","unstructured":"Stiefel HC, Sandhu RK, Miller AK, Wilson DJ, Chamberlain WD. Characterization of corneal deposition keratopathy in the setting of blood cell dyscrasia and a minimally invasive technique to clear the cornea in a single case. 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Ophthalmology. 2015;122(9):1748\u201356.","journal-title":"Ophthalmology"}],"container-title":["BMC Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12886-024-03487-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12886-024-03487-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12886-024-03487-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T22:01:38Z","timestamp":1718834498000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcophthalmol.biomedcentral.com\/articles\/10.1186\/s12886-024-03487-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,19]]},"references-count":10,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["3487"],"URL":"https:\/\/doi.org\/10.1186\/s12886-024-03487-6","relation":{},"ISSN":["1471-2415"],"issn-type":[{"value":"1471-2415","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,19]]},"assertion":[{"value":"14 June 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 May 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 June 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"We have obtained the patient\u00b4s signed informed consent for publication of her data and images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests. We confirm that this work is original and has not been published elsewhere, nor it is currently under consideration for publication elsewhere. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"263"}}