Cryoglobulinemia from different medical point of view.

Abstract

Summary

Cryoglobulinemia from different medical point of view.

Cryoglobulinemia is defined as the persistent presence of abnormal serum immunoglobulins that precipitate at low temperatures and dissolve again upon warming. Cryoglobulins may be composed by a monoclonal Ig (type I cryoglobulinemia), by a monoclonal Ig bound to the constant domain of polyclonal Ig heavy chains (type II cryoglobulinemia), or by polyclonal Igs (type III cryoglobulinemia). Cryoglobulinemia type II and III are called mixed cryoglobulinemia. Clinical manifestations of type I cryoglobulinemia are often related to intravascular obstruction, whereas those seen in the mixed cryoglobulinemias often originate in true immune complex-mediated vasculitis. The main clinical manifestations affect the skin (purpura, necrotic ulcers), joints, peripheral nervous system, and kidneys (membranoproliferative glomerulonephritis). Patients with type I and II cryoglobulinemia should be investigated for monoclonal gammopathy and lymphoproliferative diseases, Patients with type III cryoglobulinemia should be investigated for Hepatitis C, HIV and connective tissue disease.

Keywords: cryoglobulin; monoclonal gammopathy; hepatitis C; vasculitis