Cryoglobulinemia

Cryoglobulinemia General Information

Cryoglobulinemia represents the high amount of heavy globulins (proteins called cryoglobulins, such as IgM) inside the bloodstream. They become like a gel, because they thicken when the body is exposed to cold. This happens because at low temperatures these proteins clump together (precipitate). The cryoglobulins contain some proteins, immunoglobulins also known as antibodies. In a normal healthy body they uphold the fight against any infection. Sometimes, Cryoglobulinemia can be associated with other diseases, for example: lymphoma, liver disease, infections, multiple myeloma and connective disease of the tissues. What causes the disorder is yet unknown, although it was frequently met in association with some diseases such as hepatitis C. Everyone can be affected although most of the patients have between forty and fifty years old. Both men and women, in most of the cases, are predisposed to this illness that can not be inherited. Studies have showed that this disorder can be divided in three categories. The first type is common among patients with a dyscrasia of the plasma cells, for example Waldenström macroglobulinemia or multiple myeloma. The next two types are very often seen in association with hepatitis C. The proteins found in the blood stream may also exist in multiple myeloma, mycoplasma Pneumonia, autoimmune diseases (rheumatoid arthritis, systemic lupus erythematosus) and certain leukemias, for example primary macroglobulinemia. Monoclonal immunoglobulins and hematological malignancies lead to the appearance of the hyperviscosity.

Cryoglobulinemia Symptoms

Cryoglobulinemia is a disease that can appear alone, but there are cases in which it can develop from other disorders. Such diseases can include infections, especially the hepatitis C infection, blood cancers which can include lymphoma and multiple myeloma, connective tissue condition. The disease is also classified in three categories, depending on what causes the medical condition (we have mentioned these causes above). The three forms of the disease consist in: type I with multiple myeloma, and type II and III. Type III is the most common form and it is associated with the hepatitis virus. In most of the cases, patients suffering from Cryoglobulinemia have no signs and symptoms at all. But there are cases in which some signs and symptoms do appear and they depend on the type of the cryoglobulin that has been affected. They can include fatigue, joint pain or a rash that appears in form of some purple bruises, mostly, in the superior area of the legs. There are other many typical signs and symptoms of the disease which can include changing of the color of hands or feet, from normal color to a white or a purple and blue color, in combination with cold, a condition also known as Raynaud’s Phenomenon, weight loss, high blood pressure, swelling of ankles or legs, numbness, tingling, or weakness in the hands and feet, skin ulcers or gangrene, enlarged liver and spleen, abdominal and stomach pain, kidney affection and a inflammation of the blood vessels, also known as vasculitis. The main form of treatment of this kind of disease is cryofiltration.

Cryoglobulinemia Treatment

If you develop any of the symptoms characteristic for Cryoglobulinemia, you should call your health care provider, as well as if you know you suffer of hepatitis C. In case you already know that you have this type of disease and your signs and symptoms get worse, you should establish an appointment with a specialist. The doctor will ask about your signs and symptoms and then he will have to perform some medical tests. These include: complete blood count (CBC), biopsy of some elevated areas of the skin, complement assay to see if the values of the CBC are low, urinalysis (used to see if the patient’s urine has any blood in its composition and if it does, it will be a sign that the kidneys are damaged), cryoglobulin test, that will reveal the presence of cryoglobulins, rheumatoid factor, that will appear positive in the last two types, and function tests of the liver, that could be high. There are many more others tests that can include X-rays of the chest area, tests for hepatitis C, protein electrophoresis - serum, angiogram, tests for the nerve conduction (when the patient complains of weakness of his legs and arms), and ESR procedure. The results of some of these tests are combined and the final exact diagnose of Cryoglobulinemia is finally established.

Once the diagnosis is known for sure the doctor can proceed with the adequate treatment. When the patient is dealing with a mild form of the Cryoglobulinemia, the treatment has the goal to treat the underlying causes. Once these causes are treated, this type of disease can be considered fully cured. There is another typical way to treat this kind of disorder: by avoiding areas with a cold temperature leading to a good improvement. If the patient also has hepatitis C in combination with the Cryoglobulinemia, the basic treatment against the hepatitis is sometimes enough. This kind of therapy usually contains Interferon alpha along with Ribavirin. But in most cases the disease returns once the treatment is stopped. When this condition attacks larger areas of the skin and the vital organs, this disorder is considered to be severe and needs therapy based on corticosteroids and drugs that have the effect of suppressing the body’s immune system. The patient may also need that his or her plasma being cleaned; the process is known as plasmapheresis. A treatment that is now under investigation by the specialists is the one based on rituximab. There are clinics that are specialized in the diagnosis and the treatment of this rare illness of the blood. Many teams of physicians work hard day by day to develop new treatments based on the patient’s health problems and needs. When Cryoglobulinemia affects the kidneys, it has an outlook, generally poor, and in most of the cases is not fatal to the individual. This kind of disease can have many complications if it is left untreated, that can include heart disease, ulcers infections, kidney dysfunctions, bleeding of the digestive tract or failure of the liver and kidney.