Characteristics and outcome of 49 patients with symptomatic cryoglobulinaemia.
OBJECTIVE
To describe a population of patients with symptomatic cryoglobulinaemia, comparing manifestations and outcome as a function of hepatitis C virus (HCV) status.


METHODS
A retrospective study on 179 patients who tested positive for cryoglobulins, seen between 1978 and 1998 in an internal medicine department.


RESULTS
Among 179 cryoglobulin-positive patients, only 49 (18 men, 31 women; mean age 59.96+/-12 yr) had clinical manifestations attributable to cryoglobulinaemia. Thirty-three had HCV infection, 20 had systemic autoimmune diseases, two had haematological diseases, one had human immunodeficiency virus and HCV co-infection, one had HCV and HBV co-infection and six had essential mixed cryoglobulinaemia. The clinical manifestations and cryoglobulin levels in HCV(+) and HCV(-) patients did not differ significantly. Only arthralgias and elevated transaminases were significantly more frequent in HCV(+) patients (P<0.02 and <0.05, respectively). Five-year survival rates were comparable for HCV(+) and HCV(-) patients. Eight patients died (six HCV(+), two HCV(-)), with a median time between diagnosis and death of 38.7 months.


CONCLUSIONS
Clinical manifestations of cryoglobulinaemia, except arthralgias, were comparable for HCV(+) and HCV(-) patients. When systemic manifestations are present, the prognosis is poor despite intensive or prolonged therapy.
Rieu
V
V
Department of Internal Medicine, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, Université Paris-Nord, 125 rue de Stalingrad, 93009 Bobigny Cedex, France.
Cohen
P
P
André
M-H
MH
Mouthon
L
L
Godmer
P
P
Jarrousse
B
B
Lhote
F
F
Ferrière
F
F
Dény
P
P
Buchet
P
P
Guillevin
L
L
D003449:Cryoglobulinemia / Q000097:blood / Q000150:complications* / Q000821:virology; D003450:Cryoglobulins / Q000032:analysis; D004359:Drug Therapy, Combination; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D006508:Hepatitis Antibodies / Q000097:blood; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000032:analysis; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D015996:Survival Rate; D016896:Treatment Outcome
D003450:Cryoglobulins; D005938:Glucocorticoids; D006508:Hepatitis Antibodies; D016898:Interferon-alpha; D012367:RNA, Viral