title: Characteristics and outcome of 49 patients with symptomatic cryoglobulinaemia.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, Université Paris-Nord, 125 rue de Stalingrad, 93009 Bobigny Cedex, France.
authors.forename: V
authors.initials: V
authors.lastname: Rieu
authors.forename: P
authors.initials: P
authors.lastname: Cohen
authors.forename: M-H
authors.initials: MH
authors.lastname: André
authors.forename: L
authors.initials: L
authors.lastname: Mouthon
authors.forename: P
authors.initials: P
authors.lastname: Godmer
authors.forename: B
authors.initials: B
authors.lastname: Jarrousse
authors.forename: F
authors.initials: F
authors.lastname: Lhote
authors.forename: F
authors.initials: F
authors.lastname: Ferrière
authors.forename: P
authors.initials: P
authors.lastname: Dény
authors.forename: P
authors.initials: P
authors.lastname: Buchet
authors.forename: L
authors.initials: L
authors.lastname: Guillevin
mesh_terms: 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
chemical_list: D003450:Cryoglobulins; D005938:Glucocorticoids; D006508:Hepatitis Antibodies; D016898:Interferon-alpha; D012367:RNA, Viral