Last reviewed: November 2017
Last updated: August  2017

Summary

Definition

History and exam

Key diagnostic factors

  • arthralgia
  • weakness
  • vasculitis
  • lower-extremity vascular purpura

Other diagnostic factors

  • peripheral neuropathy
  • sicca symptoms
  • hypertension
  • Raynaud phenomenon
  • lower extremity skin ulcers
  • diplopia
  • ataxia
  • headache
  • confusion
  • retinal hemorrhage/retinal vein thrombosis
  • acrocyanosis

Risk factors

  • hepatitis C virus (HCV) infection
  • other viral infections
  • autoimmune disorders
  • lymphoproliferative disorders

Diagnostic investigations

1st investigations to order

  • fasting qualitative serum cryoglobulins
  • CBC
  • comprehensive chemistry panel
  • ESR, CRP
  • urinalysis
  • ECG
  • CXR
  • rheumatoid factor
  • complement CH50, C3, C4
  • HCV antibody
  • hepatitis B virus antibody
Full details

Investigations to consider

  • HIV antibody
  • ANA, SSA, ENA
  • skin biopsy
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Professor of Medicine

Chief, Division of Rheumatology and Clinical Immunology

Medical Director, Musculoskeletal Ultrasound Program

Program Director, Rheumatology Fellowship

University of Florida College of Medicine - Jacksonville

Jacksonville

FL

Disclosures

GSK declares that he has no competing interests.

Peer reviewers VIEW ALL

Rheumatologist

Road Clinic

Lakewood

WA

Disclosures

DT has received a fee from an educational grant from the Center of Excellence for organizing CME South Sound Bond Club conference.

Associate Professor

University of Turin

Chief

Myeloma Unit

Ospedale Molinette

Turin

Italy

Disclosures

AP declares that he has no competing interests.

Instructor in Hematology

Department of Hematology

Hopital Huriez CHRU

Lille

France

Disclosures

XL has received lecture fees and research funding from Janssen-Cilag, Celgene, Chugai, Amgen, Novartis, Mundipharma, and Roche. XL is an author of a number of references cited in this monograph.

Consultant Physician and Rheumatologist

Centre for Rheumatic Diseases

Glasgow Royal Infirmary

Glasgow

UK

Disclosures

RM declares that he has no competing interests.

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