[Pseudoleukocytosis in cryoglobulinemia type I].
During routine clinical and laboratory examinations of a symptom-free 54-year-old man a leukocytosis was repeatedly noted, but no cause found. 11 months later a painful spontaneously disappearing cyanosis occurred in two fingers of his right hand. Serum analysis demonstrated monoclonal type IgG-kappa immunoglobulin and an antinuclear antibody titre of 1:160. Skin biopsy suggested scleroderma. 4 months later, after exposure to cold, extensive acral haemorrhages occurred. Serum cryoglobulin concentration in serum was found to be 800 mg/dl. Comparative manual and electronic counts on warm and cooled blood identified the previously diagnosed leukocytosis as a typical artefact associated with cryoglobulinaemia. Treatment with chlorambucil (10-20 mg/d) and prednisolone (25 mg/d), for 14 days every 4 weeks, and finally interferon alpha-2b (5 mill. IU/d) reduced the cryoglobulin concentration to 150 mg/dl. Acral cyanosis and haemorrhages have not recurred since then. No cause of the cryoglobulinaemia has been found.
Wöltjen
H H
HH
Abteilung für Hämatologie und Onkologie, Augusta-Kranken-Anstalt Bochum.
Hansmann
E
E
Bremer
K
K
D001706:Biopsy; D002699:Chlorambucil / Q000008:administration & dosage; D003080:Cold Temperature / Q000009:adverse effects; D003449:Cryoglobulinemia / Q000145:classification / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D003450:Cryoglobulins / Q000032:analysis; D004359:Drug Therapy, Combination; D006801:Humans; D007145:Immunoglobulin kappa-Chains / Q000097:blood; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage; D007958:Leukocyte Count; D007964:Leukocytosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage; D011994:Recombinant Proteins; D012867:Skin / Q000473:pathology; D013997:Time Factors
D003450:Cryoglobulins; D007145:Immunoglobulin kappa-Chains; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D002699:Chlorambucil; D011239:Prednisolone