Exploring Cryoglobulinemia's Clinical Odyssey: A Case Series

EJHaem Pub Date : 2025-04-02 DOI:10.1002/jha2.70029

Shivangini Duggal, Lakshmi Vaishnavi Prasanna Kattamuri, Michel Toutoungy, Eder Luna Ceron, Madhumita Rondla, Angelica Lehker

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Abstract

Cryoglobulinemia (CG) encompasses disorders in which immunoglobulins precipitate at low temperatures. According to Brouet's classification, Type I CG is linked to plasma cell disorders, while mixed CG (Types II and III) is associated with autoimmune conditions, infections (notably hepatitis C virus [HCV]), and lymphoproliferative disorders. Each type presents distinct symptoms, with Type I often causing severe vasomotor symptoms and Types II and III involving systemic features like purpura, Raynaud's phenomenon, and renal involvement. This case series presents three CG cases, illustrating diverse etiologies and presentations. Case 1 discusses CG in metastatic colon cancer with Staphylococcus aureus bacteremia, highlighting infection-triggered CG. Case 2 covers HCV-related mixed CG, emphasizing antiviral therapy's role. Case 3 describes a CG flare after rituximab therapy, managed with steroids. These cases emphasize a multidisciplinary approach and individualized management to address CG's complexity and improve patient outcomes.

Clinical Trial Registration: The authors have confirmed clinical trial registration is not needed for this submission.

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探索低温球蛋白血症的临床奥德赛：一个病例系列

低温球蛋白血症（CG）包括免疫球蛋白在低温下沉淀的疾病。根据Brouet的分类，I型CG与浆细胞疾病有关，而混合型CG （II型和III型）与自身免疫性疾病、感染（特别是丙型肝炎病毒[HCV]）和淋巴细胞增生性疾病有关。每种类型都有不同的症状，I型通常引起严重的血管舒缩症状，II型和III型涉及全身特征，如紫癜、雷诺现象和肾脏受累。本病例系列介绍了三个CG病例，说明了不同的病因和表现。病例1讨论了转移性结肠癌伴金黄色葡萄球菌菌血症的CG，强调了感染引发的CG。病例2涉及hcv相关的混合CG，强调抗病毒治疗的作用。病例3描述了利妥昔单抗治疗后的CG耀斑，用类固醇治疗。这些病例强调多学科的方法和个性化的管理，以解决CG的复杂性和改善患者的结果。临床试验注册：作者已确认本次提交不需要临床试验注册。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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EJHaem

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