Cryoglobulinemia is the presence of abnormal proteins in the blood. These proteins thicken in cold temperatures.
Cryoglobulins are antibodies. It is not yet known why they become solid or gel-like at low temperatures in the laboratory. In the body, these antibodies can form immune complexes that can cause inflammation and block blood vessels. This is called cryoglobulinemic vasculitis. This may lead to problems ranging from skin rashes to kidney failure.
Cryoglobulinemia is part of a group of diseases that cause damage and inflammation of the blood vessels throughout the body (vasculitis). There are three main types of this condition. They are grouped based on the type of antibody that is produced:
Types II and III are also referred to as mixed cryoglobulinemia.
Type I cryoglobulinemia is most often related to cancer of the blood or immune systems.
Types II and III are most often found in people who have a long-lasting (chronic) inflammatory condition, such as an autoimmune disease or hepatitis C. Most people with the type II form of cryoglobulinemia have a chronic hepatitis C infection.
Other conditions that may be related to cryoglobulinemia include:
Symptoms will vary, depending on the type of disorder you have and the organs that are involved. Symptoms may include:
The health care provider will do a physical exam. You will be checked for signs of liver and spleen swelling.
Tests for cryoglobulinemia include:
Other tests may include:
MIXED CRYOGLOBULINEMIA (TYPES II AND III)
Mild or moderate forms of cryoglobulinemia can often be treated by taking steps to deal with the underlying cause.
Current direct-acting medicines for hepatitis C eliminate the virus in nearly all people. As hepatitis C goes away, the cryoglobulins will disappear in about one half of all people over the next 12 months. Your provider will continue to monitor the cryoglobulins after treatment.
Severe cryoglobulinemia vasculitis involves vital organs or large areas of skin. It is treated with corticosteroids and other medicines that suppress the immune system.
TYPE I CRYOGLOBULINEMIA
This disorder is due to a cancer of the blood or immune system such as multiple myeloma. Treatment is directed against the abnormal cancer cells that produce the cryoglobulin.
Most of the time, mixed cryoglobulinemia does not lead to death. Outlook can be poor if the kidneys are affected.
Call your provider if:
There is no known prevention for the condition.
DiGuardo MA, Bobr A, Winters JL. Hemapheresis. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 38.
Roccatello D, Saadoun D, Ramos-Casals M, et al. Cryoglobulinaemia. Nat Rev Dis Primers. 2018;4(1):11. PMID: 30072738 pubmed.ncbi.nlm.nih.gov/30072738/.
Stone JH. Immune complex-mediated small-vessel vasculitis. In: Firestein GS, Budd RC, Gabriel SE, Koretzky GA, McInnes IB, O’Dell JR, eds. Firestein & Kelley's Textbook of Rheumatology. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 96.BACK TO TOP
Review Date: 1/31/2021
Reviewed By: Diane M. Horowitz, MD, Rheumatology and Internal Medicine, Northwell Health, Great Neck, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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