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. The gene discussed is CD40LG; the disease is cryoglobulinemia.