New insights in cryoglobulinemic vasculitis

Journal of Autoimmunity
Filipa SilvaJorge Almeida

Abstract

Cryoglobulins are antibodies that precipitate at low temperatures and dissolve after rewarming. Cryoglobulinemia refers to the presence of circulating cryoglobulins and generally leads to a systemic inflammatory syndrome characterized by fatigue, arthralgia, purpura, ulcers, neuropathy and/or glomerulonephritis. The disease mainly involves small to medium-sized blood vessels and causes vasculitis due to cryoglobulin-containing immune complexes. Cryoglobulinemia is classified into three types (I, II and III) on the basis of immunoglobulin composition. Predisposing conditions include lymphoproliferative, autoimmune diseases and hepatitis C virus infection. The diagnosis of cryoglobulinemic syndrome is predominantly based on the presence of clinical features and laboratorial demonstration of serum cryoglobulins. The treatment strategy depends on the cause of cryoglobulinemia. For patients with chronic HCV infection, antiviral therapy is indicated. Immunosuppressive or immunomodulatory therapy, including steroids, plasmapheresis and cytotoxic agents, is reserved for organ-threatening manifestations. In this review, we discuss the main clinical presentations, diagnostic approach and treatment options.

Citations

Oct 2, 2020·Der Nervenarzt·Felix KleefeldUNKNOWN Deutsche Gesellschaft für Neuro-AIDS und Neuro-Infektiologie (DGNANI)
Nov 30, 2020·Allergy·Natalya MaltsevaUNKNOWN COLD-CE Steering Committee
Jan 29, 2021·World Journal of Gastroenterology : WJG·Chrong-Reen Wang, Hung-Wen Tsai
Dec 3, 2020·Minerva medica·Elena TreppoSalvatore DE Vita
Dec 15, 2020·Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases·Mittermayer B Santiago, Adriane Paz
Jun 11, 2021·The Journal of Dermatology·Shin IinumaAkemi Ishida-Yamamoto
Aug 21, 2021·Pediatric Neurology·Meeta CardonChandra Krishnan
Nov 10, 2021·Expert Review of Clinical Immunology·Norman Latov

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