Essential mixed cryoglobulinemia

General or Other | General Practice | Essential mixed cryoglobulinemia (Disease)


Cryoglobulinemia is a medical condition in which the blood contains large amounts of cryoglobulins - proteins that become insoluble at reduced temperatures. Cryoglobulins typically precipitate at temperatures below normal body temperature (37 degrees Celsius) and will dissolve again if the blood is heated. 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.

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.

Causes and Risk factors

Cryoglobulinemia is a medical condition that is caused by proteins called cryoglobulins, which are present in the blood. Cryoglobulins are abnormal proteins that by definition have the unusual property of precipitating from the serum specimen when it is chilled in the laboratory and redissolving into the serum upon rewarming.

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.

These proteins may be present in mycoplasma pneumonia, post streptococcal glomerulonephritis, multiple myeloma, certain leukemias, primary macroglobulinemia, and some autoimmune diseases, such as systemic lupus erythematosus and rheumatoid arthritis. This is also found occasionally as a symptom in 35% of chronic hepatitis C infections. It can also occur in hepatitis B and and human immunodeficiency virus infections.

Diagnosis and Treatment

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.

Essential mixed cryoglobulinemia is treated with combinations of medications which reduce inflammation and suppress the immune system. ...

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