These findings raised suspicion for an underlying plasma cell dyscrasia with WM, IgM-monoclonal gammopathy of undetermined significance (MGUS), and IgM-related disorders (amyloid light-chain (AL) amyloidosis, cryoglobulinemia, POEMS (Polyneuropathy, Organomegaly, Endocrinopathy, M-protein, and Skin changes) syndrome, and CANOMAD (Chronic Ataxic Neuropathy, Ophthalmology, IgM paraprotein, Cold Agglutinins, and Disialosyl antibodies) syndrome) being the top differentials. Here, CD40LG is linked to chronic obstructive pulmonary disease.