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Cryoglobulinemia

Last reviewed: 4 Oct 2024
Last updated: 10 May 2024

Summary

Definition

History and exam

Key diagnostic factors

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

Other diagnostic factors

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

Risk factors

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

Diagnostic tests

1st tests to order

  • fasting qualitative serum cryoglobulins
  • CBC
  • comprehensive chemistry panel
  • erythrocyte sedimentation rate, CRP
  • urinalysis
  • ECG
  • CXR
  • rheumatoid factor
  • complement CH50, C3, C4
  • hepatitis C virus (HCV) antibody
  • hepatitis B virus antibody
Full details

Tests to consider

  • HIV antibody
  • antinuclear antibody (ANA), Sjogren syndrome antigens, extractable nuclear antigen (ENA) antibody
  • skin biopsy
Full details

Treatment algorithm

ACUTE

mixed cryoglobulinemia

malignancy-associated cryoglobulinemia (type I)

Contributors

Authors

Gurjit S. Kaeley, MBBS, MRCP

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

Morie Gertz, MD

Professor of Medicine

Division of Hematology

Mayo Clinic

Rochester

MN

Disclosures

MG is an author of a number of references cited in this topic.

Antonio Palumbo, MD

Associate Professor

University of Turin

Chief

Myeloma Unit

Ospedale Molinette

Turin

Italy

Disclosures

AP declares that he has no competing interests.

Xavier Leleu, MD, PhD

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 topic.

Rajan Madhok, MD, FCRP

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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