Mixed cryoglobulinemia and vasculitis: a novel pathogenic mechanism.
We describe a patient with lymphoma and mixed cryoglobulinemia who developed vasculitis and membranoproliferative glomerulonephritis concomitant with severe decreases in serum IgG and complement levels. At the time of her demise, her serum cryoglobulin solubility had decreased compared to a specimen obtained when she was asymptomatic. This suggests that a change in antigen-antibody ratio of her cryoglobulin towards immune equivalence, due to decreased available antigen (IgG), was responsible for the development of immune complex vasculitis.
Wooten
M D
MD
Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock 72205, USA.
Jasin
H E
HE
D000361:Agammaglobulinemia / Q000097:blood / Q000150:complications; D003450:Cryoglobulins / Q000378:metabolism*; D017809:Fatal Outcome; D005260:Female; D015432:Glomerulonephritis, Membranoproliferative / Q000097:blood / Q000209:etiology / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000097:blood / Q000150:complications; D008875:Middle Aged; D010265:Paraproteinemias / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D014657:Vasculitis / Q000097:blood / Q000209:etiology / Q000503:physiopathology*
D003450:Cryoglobulins; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M