What are cryoglobulins?
Cryoglobulins are proteins found in the blood that
precipitate (clump together) in the cold and cause organ damage. However, these
proteins can occasionally be present in the blood without any symptoms. When
there are symptoms due to the cryoglobulins, the disease is called "cryoglobulinemia."
What are the symptoms of cryoglobulinemia?
Most people with cryoglobulins have no symptoms other
than elevated levels on lab tests. When symptoms are present, they are most
commonly fatigue, joint pain, numbness or weakness, and a rash that looks like
purple bruises, usually over the legs.
Other symptoms and signs may include:
- Change of the color of hands and/or feet (from normal to white to a
purplish-blue color) with cold, called "Raynaud's Phenomenon"
- Weight loss
- High blood pressure
- Swelling of ankles and legs
- Skin ulcers and gangrene
- Enlarged liver or spleen
- Abdominal pain
- Kidney damage
What causes cryoglobulinemia?
Cryoglobulinemia can be present alone or can be
associated with other diseases such as:
- Infection, particularly hepatitis C infection
- Blood cancers such as lymphoma and multiple myeloma
- Connective tissue disease such as lupus
How is cryoglobulinemia diagnosed?
Cryoglobulinemia is diagnosed by a specific blood test
that will recognize the presence of cryoglobulins in the blood. Classification
of the type of cryoglobulins can sometimes help in differentiating the cause of
cryoglobulinemia.
How is cryoglobulinemia treated?
Treatment of cryoglobulinemia depends on the organ
affected and the extent of the damage as well as on the presence of other
associated conditions. It is very important not only to treat the
cryoglobulinemia but also to address any other associated disorders.
The mainstay of treatment is corticosteroids with or
without other immunosuppressive medications depending on the affected organ and
the extent of involvement.
Another form of treatment aims to diminish the amount
of cryoglobulins in the blood. This can be done by plasma exchange, a treatment
referred to as "plasmapheresis."
If another associated disorder has been found, such as
hepatitis C, interferon-alpha may be recommended with a referral to a
hepatologist (liver specialist).
If multiple myeloma or lymphoma is identified, a
referral to a hematologist is recommended.
References
The Merck Manuals Online Medical Library. Dysproteinemias Causing Vascular Purpura.
www.merck.com.
Accessed 7/2010
Lab Tests Online. American Association of Clinical Chemistry. Cryoglobulin.
www.labtestsonline.org.
Accessed 7/2010