title: Mixed cryoglobulinemia secondary to visceral Leishmaniasis.
abstract: We describe a case of type II mixed cryoglobulinemia, with monoclonal IgMkappa rheumatoid factor, associated with visceral leishmaniasis caused by Leishmania infantum. Involvement of Leishmania antigen(s) in the formation of cryoprecipitable immune complexes was suggested by the fact that cryoglobulinemic vasculitis subsided after antiparasite therapy and that anti-Leishmania antibodies, as well as rheumatoid factor, were enriched in the cryoprecipitate. We observed 2 additional patients with visceral leishmaniasis and cryoglobulinemic vasculitis. All 3 patients had seemingly contracted leishmaniasis in Italy, were hepatitis C virus negative, and were initially diagnosed as having autoimmune disorders. These findings indicate that Leishmania can be an etiologic agent of type II mixed cryoglobulinemia. This parasitosis should be taken into consideration in the differential diagnosis of vasculitides in endemic areas.
authors.affiliation: University of Rome La Sapienza, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Casato
authors.forename: F G
authors.initials: FG
authors.lastname: de Rosa
authors.forename: L P
authors.initials: LP
authors.lastname: Pucillo
authors.forename: I
authors.initials: I
authors.lastname: Ilardi
authors.forename: B
authors.initials: B
authors.lastname: di Vico
authors.forename: L R
authors.initials: LR
authors.lastname: Zorzin
authors.forename: M L
authors.initials: ML
authors.lastname: Sorgi
authors.forename: P
authors.initials: P
authors.lastname: Fiaschetti
authors.forename: R
authors.initials: R
authors.lastname: Coviello
authors.forename: B
authors.initials: B
authors.lastname: Laganà
authors.forename: M
authors.initials: M
authors.lastname: Fiorilli
mesh_terms: D000328:Adult; D000818:Animals; D000953:Antigens, Protozoan / Q000097:blood; D003449:Cryoglobulinemia / Q000097:blood / Q000150:complications* / Q000276:immunology; D006801:Humans; D007891:Leishmania / Q000276:immunology; D007898:Leishmaniasis, Visceral / Q000209:etiology*; D008297:Male; D014657:Vasculitis / Q000175:diagnosis
chemical_list: D000953:Antigens, Protozoan