Cryoglobulinemia

 

 

Cryoglobulinemia is the presence in the blood, more specifically, the blood serum (in its liquid), immunoglobulin is owned precipitate (condense, to appear) in a reversible manner (so final), and this at a temperature below 37 ° centigrade.

General;


Cryoglobulins are immunoglobulins that is to say antibodies present in the blood and may be transformed under the effect of a temperature below 30 ° centigrade. Cryoglobulinemia is the result of a breach of the tiny vessels in certain organs in particular of peripheral nerves of the kidneys.
Cryoglobulinemia appears during certain pathologies (non exhaustive list):
• Infections, mainly hepatitis C, favor the appearance of mixed cryoglobulinemia.
• Bacterial and parasitic infections such as toxoplasmosis , the kala-azar , schistosomiasis, etc.)..
• Blood diseases (hematologic malignancies), particularly lymphoproliferative disorders such as lymphoma malignant non-Hodgkin lymphomas, the leukemias , especially chronic lymphocytic leukemia, the Waldenstrom's macroglobulinemia .
• Autoimmune diseases ( systemic lupus erythematosus , Sjogren's syndrome , rheumatoid arthritis).
• Cryoglobulinemic vasculitis.


Classification:


There are three types of cryoglobulinemia:
• Monoclonal cryoglobulinemia type I in which one monoclonal immunoglobulin is involved.
• Mixed cryoglobulinemia type II aut in which a monoclonal immunoglobulin IgM directed against IgG immunoglobulins.
• Mixed cryoglobulinemia type III in which one or more classes of immunoglobulins polyclonal s involved.

Causes:
• This disease is a disease caused by a disorder of the immune system of the body.
• Immunoglobulins will persist in the blood and precipitate in the cold.
• Then they will regroup when blood is warming.
• This is the precipitation of cryoglobulins in the blood, more specifically serum cooled, which may damage the tiny vessels. Indeed, there is then the onset of inflammation of vessel walls, known as cryoglobulinemic vasculitis, throughout the peripheral nervous system (nerves themselves) and kidneys. .

Symptoms:
• Onset of pain in the joints.
• Of purpura (red violet color spot will appear on the skin, due to the migration of blood within the blood flow to the skin).
• Of Raynaud's syndrome .
• Cryoglobulinemic kidney glomerular disease (glomerulus).
• Of peripheral polyneuropathy .

Sometimes cryoglobulinemia no symptoms, we say it is asymptomatic and is discovered by chance in this case, while the patient performs a blood test for another disease. From that moment on, we find a change of blood serum, which appears opalescent, it is stored in the refrigerator.

Technical:
Laboratory tests reveal the presence of cryoglobulins in the blood, after making a withdrawal, and separation of serum at 37 ° centigrade, then storage at 4 ° over for a week. There is also a decrease in the hemolytic complement (CH50) and C4.

Treatment;
The treatment is of course that the cause (hepatitis, malignancy, infection, etc.)..
It is sometimes necessary to plasma exchange , especially when there is a severe form, that is to say when there is an ischemia with decreased among others, blood, the kidneys and bodies. The administration of alpha interferon and prednisolone occurs for varieties infectious diseases (hepatitis C)