Introduction In 1943, Waldenstrom20 first described "purpura hyperglobulinemica." The essential features of this syndrome included the presence of a recurrent purpuric eruption of the legs, chronic increase in the serum γ-globulin, elevated erythrocyte sedimentation rate, mild normochromic anemia, and a benign course. Since the initial report of this dysproteinemic purpura, more than three dozen additional cases of the primary or idiopathic type have been recorded. Recently Hambrick7 summarized the first twenty cases and added one of his own. Another fourteen cases were reported by Wilson, Bolinger, and Slinker.22 Other cases have been recorded by Laurin et al.,12 Rozengvaig et al.,16 and Rogers and Welch.15 Thirty-two of the thirty-eight patients have been female, and ages have ranged from 23 to 70. The earliest age of onset was 21, and the longest reported duration of the syndrome has been 20 years. In the idiopathic group, findings