Cryoglobulinemia

Cryoglobulinemia
Classification and external resources
ICD-10	D89.1
ICD-9	273.2
DiseasesDB	3207
MedlinePlus	000540
eMedicine	med/480
MeSH	D003449

Cryoglobulinemia^[1] is a medical condition in which the blood contains large amounts of cryoglobulins - proteins that become insoluble at reduced temperatures. Cryoglobulins typically precipitate at temperatures below normal body temperature (37 degrees Celsius) and will dissolve again if the blood is heated. Cryoglobulinemia can be associated with various diseases such as multiple myeloma and hepatitis C infection.

Classification

Cryoglobulinemia is classically grouped into three types according to the Brouet classification.^[2] Type I is most commonly encountered in patients with a plasma cell dyscrasia such as multiple myeloma or Waldenström macroglobulinemia.^[3] Types II and III are strongly associated with infection by the hepatitis C virus.^[3]

There are three different types of cryoglobulins that have been observed to form in the blood.^[4]

Type	Composition	Percent	Description
Type I	isolated monoclonal immunoglobulins	10-15% of the total cases	These are composed of a single monoclonal immunoglobulin paraprotein (usually IgM). Sometimes, these are represented by light chains only and can be extracted from the urine, or they will accumulate in blood serum in the event of renal failure.[5]
Type II	immunocomplexes formed by monoclonal IgM	50-60% of reported cases	They usually have a polyclonal component, usually IgG, and a monoclonal component, usually IgM, which has an RF function. The IgM can recognize intact IgG or either the Fab region or Fc region of IgG fragments. This is why most type II cryoglobulins are IgM-IgG complexes.[5]
Type III	immunocomplexes formed by polyclonal IgM	25-30% of the reported cases	These have very similar function to the type II cryoglobulins, however they are composed of polyclonal IgM and IgG molecules.[5]

Types II and III have rheumatoid factor (RF) activity and bind to polyclonal immunoglobulins. These two types are referred to as mixed cryoglobulinemia (MC). When the temperature is raised, the precipitated cryoglobulins will dissolve back into the serum.^[5]

In 2006 it was discovered that there are unusual cryoglobulins that show a microheterogeneous composition, with an immunochemical structure that cannot be fit into any of the classifications. A classification of a type II-III variant has been proposed because they are composed of oligoclonal IgMs with traces of polyclonal immunoglobulins^[6]

Causes

These proteins may be present in mycoplasma pneumonia,post streptococcal glomerulonephritis, multiple myeloma, certain leukemias, primary macroglobulinemia, and some autoimmune diseases, such as systemic lupus erythematosus and rheumatoid arthritis,. This is also found occasionally as a symptom in 35% of chronic hepatitis C infections.^[7] It is important to note that these two different, yet highly representative, clinical syndromes generally reflect different types of underlying CG:

• Hyperviscosity is typically associated with CG due to hematological malignancies and monoclonal immunoglobulins.

• "Meltzer's triad" (purpura, arthralgia and myalgia)^[8] is generally seen with polyclonal CGs seen in essential-, viral-, or connective tissue disease-associated CG.

See also

• Cryoglobulinemic purpura
• Hematopoietic ulcer
• Paraproteinemia

References

1. ^ "cryoglobulinemia" at Dorland's Medical Dictionary
2. ^ Brouet JC, Clauvel JP, Danon F, Klein M, Seligmann M (1974). "Biologic and clinical significance of cryoglobulins. A report of 86 cases". Am. J. Med. 57 (5): 775–88. doi:10.1016/0002-9343(74)90852-3. PMID 4216269. 
3. ^ ^{a b} Ferri C, Zignego AL, Pileri SA (2002). "Cryoglobulins". J. Clin. Pathol. 55 (1): 4–13. doi:10.1136/jcp.55.1.4. PMC 1769573. PMID 11825916. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1769573. 
4. ^ "cryoglobulin" at Dorland's Medical Dictionary
5. ^ ^{a b c d} Tedeschi A, Baratè C, Minola E, Morra E (2007). "Cryoglobulinemia". Blood Rev. 21 (4): 183–200. doi:10.1016/j.blre.2006.12.002. PMID 17289231. http://linkinghub.elsevier.com/retrieve/pii/S0268-960X(06)00076-2. 
6. ^ Tissot JD, Schifferli JA, Hochstrasser DF, et al. (1994). "Two-dimensional polyacrylamide gel electrophoresis analysis of cryoglobulins and identification of an IgM-associated peptide". J. Immunol. Methods 173 (1): 63–75. doi:10.1016/0022-1759(94)90284-4. PMID 8034987. 
7. ^ Pascual M, Perrin L, Giostra E, Schifferli JA (1990). "Hepatitis C virus in patients with cryoglobulinemia type II". J. Infect. Dis. 162 (2): 569–70. doi:10.1093/infdis/162.2.569. PMID 2115556. 
8. ^ Monti G, Galli M, Invernizzi F, et al. (February 1995). "Cryoglobulinaemias: a multi-centre study of the early clinical and laboratory manifestations of primary and secondary disease. GISC. Italian Group for the Study of Cryoglobulinaemias". QJM 88 (2): 115–26. PMID 7704562. http://qjmed.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=7704562. 

External links

• Overview at Mayo Clinic

This medical sign article is a stub. You can help Wikipedia by expanding it.v · Categories: Medical signs Medical sign stubs Wikimedia Foundation. 2010. Игры ⚽ Поможем решить контрольную работу United States presidential election swing states, 2004 United States presidential election swing states, 2000 Look at other dictionaries: cryoglobulinemia — ▪ medical disorder       presence in the blood of proteins called cryoglobulins that precipitate at temperatures below 98.6° F (37° C), both in the laboratory and in the body (where the precipitation could cause circulatory impairment or blockage …   Universalium Cryoglobulinemia — The presence in blood of abnormal proteins called cryoglobulins that, by definition, have the unusual properties of precipitating from the blood serum when it is chilled and redissolving upon rewarming. (Cryoglobulins are gamma globulins with a… …   Medical dictionary cryoglobulinemia — noun A medical condition in which the blood contains an excess of cryoglobulins …   Wiktionary cryoglobulinemia — cryo·glob·u·li·ne·mia …   English syllables cryoglobulinemia — ¦krīōˌgläbyələ̇¦nēmēə noun ( s) Etymology: New Latin, from International Scientific Vocabulary cryoglobulin + New Latin emia : the condition of having abnormal quantities of cryoglobulins in the blood …   Useful english dictionary Essential mixed cryoglobulinemia — A condition in which cryoglobulin proteins which are a mixture of various antibody types form for unknown (essential) reasons. Cryoglobulins are abnormal blood proteins that, by definition, have the unusual properties of precipitating from the… …   Medical dictionary Hepatitis C — Classification and external resources Electron micrograph of hepatitis C virus purified from cell culture. The scale = 50 nanometers ICD 10 B …   Wikipedia Waldenström's macroglobulinemia — DiseaseDisorder infobox Name = Waldenström s macroglobulinemia ICD10 = ICD10|C|88|0|c|81 ICDO = ICDO|9761|3 ICD9 = ICD9|273.3 OMIM = 153600 MedlinePlus = 000588 eMedicineSubj = med eMedicineTopic = 2395 DiseasesDB = 14030 MeshID = D008258… …   Wikipedia Subacute bacterial endocarditis — Infobox Disease Name = PAGENAME Caption = DiseasesDB = ICD10 = ICD10|I|33|0|i|30 ICD9 = ICD9|421.0 ICDO = OMIM = MedlinePlus = eMedicineSubj = eMedicineTopic = MeshID = D004698 Subacute bacterial endocarditis (also called endocarditis lenta) is a …   Wikipedia Cryoglobulin — An abnormal blood protein that has the unusual properties of precipitating from the blood serum when it is chilled (hence the cryo ) and redissolving when it is rewarmed. Cryoglobulins are gamma globulins with a molecular weight of approximately… …   Medical dictionary 18+ © Academic, 2000-2024 Contact us: Technical Support, Advertising Dictionaries export, created on PHP, Joomla, Drupal, WordPress, MODx. Mark and share Search through all dictionaries Translate… Search Internet Share the article and excerpts Direct link … Do a right-click on the link above and select “Copy Link”