Managing refractory cryoglobulinemic vasculitis: challenges and solutions

Journal of Inflammation Research
Predrag Ostojic, Ivan R Jeremic

Abstract

Cryoglobulinemia is thought to be a rare condition. It may be an isolated disorder or secondary to a particular disease. According to immunoglobulin composition, cryoglobulinemia is classified into three types. In mixed cryoglobulinemia (types II and III), vascular deposition of cryoglobulin-containing immune complexes and complement may induce a clinical syndrome, characterized by systemic vasculitis and inflammation - cryoglobulinemic vasculitis (CryoVas). Most common clinical manifestations in CryoVas are skin lesions (orthostatic purpura and ulcers), weakness, peripheral neuropathy, Raynaud's phenomenon, sicca syndrome, membranoproliferative glomerulonephritis, and arthralgia and seldom arthritis. In patients with mixed cryoglobulinemia, prevalence of anti-hepatitis C virus (HCV) antibodies and/or HCV RNA, detected by polymerase chain reaction (PCR), is reported to be up to 90%, indicating a significant role of HCV in the development of this condition. The goals of therapy for mixed cryoglobulinemia include immunoglobulin level reduction and antigen elimination. CryoVas not associated with HCV infection should be treated according to treatment recommendations for small-vessel vasculitides. CryoVas associated with chronic HC...Continue Reading

Citations

Oct 24, 2019·Current Opinion in Rheumatology·Ourania D Argyropoulou, Athanasios G Tzioufas
Dec 7, 2019·Indian Dermatology Online Journal·Prabhakar M Sangolli, Dammaningala Venkataramaiah Lakshmi
Jul 30, 2020·Journal of Cardiac Surgery·Kazuhiro YamazakiKosaku Murakami
Aug 2, 2020·Digestive Diseases and Sciences·Ming-Ling ChangRong-Nan Chien
Oct 23, 2020·Journal of Investigative Medicine High Impact Case Reports·Khalid SawalhaGilbert-Roy Kamoga
Nov 30, 2020·Allergy·Natalya MaltsevaUNKNOWN COLD-CE Steering Committee
Dec 3, 2020·Minerva medica·Elena TreppoSalvatore DE Vita
Dec 4, 2020·Clinics and Research in Hepatology and Gastroenterology·Gonçalo BoletoPatrice Cacoub

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