Corneal Copper Deposition Secondary to a Variant of Multiple Myeloma: 30-Year Catamnesis

The historical association of defects in copper transport, increased serum copper levels, decreased ceruloplasmin levels, and copper deposition in the peripheral limbal cornea is well described in the clinical entity of Wilson (hepatolenticular) disease. Copper deposition in the central Descemet membrane along with anterior and posterior lens capsules has been reported in individuals with multiple myeloma,1-3 benign monoclonal gammopathy,4 and IgG monoclonal gammopathy associated with pulmonary carcinoma.5 We report a 30-year catamnesis, a follow-up medical history of a patient who was first described in the ARCHIVES in 1975. The mother and father of the patient had normal color vision by the last technique, but the patient responded as a deuteranomalous trichromat: ie, the patient required a higher fraction of green light to match the yellow test area. Evaluation of her farm water wells, cows' milk, and other possible sources of copper exposure or contamination was unrevealing. The diagnosis of multiple myeloma was made on the basis of the bone marrow biopsy, which revealed increased atypical plasma cells (12%-15%; normal,