Cryoglobulinemia

Introduction Cold globulin, also known as cold immunoglobulin, is a protein or protein complex that precipitates naturally at low temperatures and dissolves after heating. When cold globulin appears in the blood, it is called cryoglobulinemia. The clinical manifestations of this disease are variable, mainly related to the type of cold globulin. In addition to the clinical manifestations of the primary disease, some cases may be asymptomatic. Other patients often have high blood viscosity and red blood cell agglutination caused by cold globulin cold precipitation. Pathological phenomena such as thrombosis. Common symptoms include Raynaud's phenomenon (ie cold cyanosis), purpura, necrosis, ulcers, cold urticaria, joint pain, numbness, and other organs involved in the deep blood vessels involved in the kidney, brain, liver and spleen. damage.

Cause

This pathological condition is often secondary to certain primary diseases such as infections, autoimmune diseases and certain immune proliferative diseases.

an examination

1. General laboratory inspection

ESR is often increased, hemoglobin is reduced, thrombocytopenia, hemagglutination disorder, false positive reaction in laboratory research of sexually transmitted diseases, gamma globulin is increased, rheumatoid factor is often positive and titer is high.

2. gamma globulin

Increase.

3. Immunological examination

Serum complement reduction, especially C4. Rheumatoid factor, antinuclear antibody, cold globulin positive.

4. Determination of cryoglobulin

More than 90% of patients with type I and 80% of type II have a cold globulin content of >1 mg/mL, and more than 80% of type III patients have <1 mg/mL.

5.Ig check

lgM is often elevated, and some patients have increased IgG and IgA.

6. Serum complement

Type I is normal, and patients with mixed cryoglobulinemia often have a decrease in complement.

7. Other

The Coomb test was positive and positive for antinuclear antibodies. Direct immunofluorescence showed Ig, complement and fibrinogen deposition in the vessel wall.

Differential diagnosis

Condensed agglutinin

It is due to the self-aggregation in the small blood vessels after the high-priced lectin in the serum is cold. The prominent symptoms are the extremities and the nose, the cyanosis at the ear, the numbness and pain, and the hemolytic anemia and paroxysmalness. Hemoglobinuria.

2. Cold fibrinogenemia

The protein with condensation in the plasma, clinical manifestations of urticaria, numbness and bleeding of the extremities, may be primary or secondary to certain malignant diseases.

3. Hand and foot cyanosis

It is due to the spasm of the skin, the secondary hair loss caused by the secondary expansion of the capillaries and veins, and there are many spontaneous symptoms.

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