| Cryoglobulinemia
Cryoglobulinemia is a medical condition that is caused by proteins called cryoglobulins
present in the blood. Cryoglobulins are abnormal proteins that by definition have the
unusual property of precipitating from the serum specimen in the laboratory when it is
chilled and redissolving into the serum upon rewarming.
Cryoglobulins may or may not be causing disease. Cryoglobulins can accompany another
condition (such as dermatomyositis, multiple myeloma, or lymphoma) or be an isolated
condition themselves, called cryoglobulinemia.
How is Cryoglobulinemia diagnosed
The diagnosis is made by combining the information from a thorough history and physical
examination with results from blood and urine tests. At times, biopsies (small samples of
tissue) are also required. Potential biopsy sites include the skin, kidney, bone marrow,
liver, and a peripheral nerve
What are some of the underlying conditions of Cryoglobulinemia
Cryoglobulins in the blood (cryoglobulinemia) can cause conditions throughout the body.
These conditions include problems resulting from abnormal "thickness" of the
blood (such as stroke or blood clots in the eyes leading to blindness) and inflammation of
blood vessels, referred to as vasculitis. Vasculitis of arteries can result in blockage of
arteries leading to damage to the organ(s) supplied by the affected blood vessels, such as
in the skin, kidneys, or elsewhere.
What is essential mixed cryoglobulinemia?
When the cryoglobulin proteins are a mixture of various antibody types, and
forming for unknown reasons (essential), the conditions is referred to as essential mixed
cryoglobulinemia.
Essential mixed cryoglobulinemia is characterized by joint pains and swelling
(arthritis), enlargement of the spleen, skin vasculitis with purplish patches, and nerve
and kidney disease. This can lead to recurrent pain in the abdomen, heart attack, and
bleeding in the lungs. Weight loss can occur as well as poor appetite.
Essential mixed cryoglobulinemia is sometimes associated with hepatitis C virus
infection.
What is the prognosis (outlook) for patients with essential mixed cryoglobulinemia?
The prognosis and natural history of the illness is not predictable. Kidney damage can
be serious and recent reports state that permanent failure of the kidney occurs in
approximately 10 % of patients. Death can occur, usually from serious heart disease,
infection, or brain hemorrhage.
Treatment for mixed cryoglobulinemia?
Essential mixed cryoglobulinemia is treated with combinations of medications which
reduce inflammation and suppress the immune system. Medications used include nonsteroid
antiinflammatory drugs (ibuprofen, aspirin, and others), cortisone preparations
(prednisone, prednisolone), cyclophosphamide (Cytoxan), chlorambucil (Leukeran), and
azathioprine (Imuran). Plasmapheresis (hemapheresis), a procedure whereby the blood's
serum is replaced with saline (salt water), is also performed for severe symptoms.
Recent studies have demonstrated some benefit of using interferon- alpha for those
patients with evidence of hepatitis C virus, particularly those with mild disease or in
those with remission of manifestations after immune suppression treatment.
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