title: Relevance of low titers of cryoglobulins and cold-agglutinins in patients with isolated Raynaud phenomenon.
abstract: BACKGROUND
  A Raynaud phenomenon can be associated with cold agglutinins or cryoglobulins. Although cold agglutinins or cryoglobulins may lead to severe acral gangrene the finding of relevant titers is rare. Low titers of cold agglutinins or cryoglobulins are detected more frequently but are assumed to be without any importance.
  
  
  OBJECTIVE
  To prove a possible diagnostic or prognostic role of low titers of cold agglutinins or cryoglobulins in patients presenting an isolated Raynaud phenomenon we did a retrospective analysis.
  
  
  METHODS
  In 306 patients (40+/-16 years, range: 15-83 years) with a mean duration of the history of an isolated Raynaud phenomenon of 48+/-73 months we did a clinical examination, an analysis of antinuclear antibodies, extractable antibodies, cold agglutinins, cryoglobulins, plasma and blood viscosity, erythrocyte aggregation and a nail fold capillaroscopy.
  
  
  RESULTS
  Low titers of cold agglutinins were found in 49 patients and of cryoglobulins in 7 patients. The finding of such low titers was not associated with extensive clinical symptoms, duration of clinical symptoms, megacapillaries or haemorrhagies in capillaroscopy, pathologic plasma and blood viscosity and erythrocyte aggregation. The follow-up investigations (mean: 3.1+/-1.2 years, range: 3-7 years) revealed no development of a haematological, vasculitic or connective tissue disease in the subgroup of patients who only had low titers of cold agglutinins.
  
  
  CONCLUSIONS
  The detection of low titers of cold agglutinins in patients with isolated Raynaud phenomenon is of no diagnostic or prognostic relevance.
authors.affiliation: Klinik für Angiologie, University of Essen, Germany. knut.kroeger@uni-essen.de
authors.forename: K
authors.initials: K
authors.lastname: Kröger
authors.forename: T
authors.initials: T
authors.lastname: Billen
authors.forename: G
authors.initials: G
authors.lastname: Neuhaus
authors.forename: F
authors.initials: F
authors.lastname: Santosa
authors.forename: C
authors.initials: C
authors.lastname: Buss
authors.forename: E
authors.initials: E
authors.lastname: Kreuzfelder
authors.forename: K B
authors.initials: KB
authors.lastname: Henneberg-Quester
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000373:Agglutinins / Q000097:blood*; D000974:Antibodies, Antinuclear / Q000097:blood; D001323:Autoantibodies / Q000097:blood; D001809:Blood Viscosity; D002196:Capillaries / Q000473:pathology / Q000503:physiopathology; D003450:Cryoglobulins / Q000032:analysis*; D004903:Erythrocyte Aggregation; D005260:Female; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D009262:Nails / Q000098:blood supply; D017534:Radial Artery / Q000503:physiopathology; D011928:Raynaud Disease / Q000097:blood* / Q000276:immunology / Q000503:physiopathology; D012016:Reference Values; D017535:Ulnar Artery / Q000503:physiopathology
chemical_list: D000373:Agglutinins; D000974:Antibodies, Antinuclear; D001323:Autoantibodies; D003450:Cryoglobulins; C029443:cold agglutinins