[Mixed cryoglobulinemia with monoclonal IgA and biclonal IgM during hepatitis C virus infection].
Cryoglobulins are immunoglobulins that precipitate at low temperature and dissolve when warmed. According to Brouet, their classification relies upon the immunochemical study: type I comprises monoclonal immunoglobulins (IGG), when types II and III include both monoclonal and polyclonal components. During C hepatitis, the presence of a cryoglobulin, essentially made of mixed G-IGG and M-IGG, is a common feature with a prevalence of 40 to 80%. The authors report a case of a 63-year patient who presented with a vascular purpura and a peripheral polyneuropathy in a context of C hepatitis infection. The cryoglobulin found was composed of a monoclonal kappa A-IgG associated with a biclonal kappa and lambda M-IgG. No decrease of normal IgGs was found. This type of cryoglobulin does not belong to Brouet's classification, and argues for a new and more pertinent classification to be proposed.
Abdi
S
S
Service de Médicine interne A, Hôpital Ibn-Sina, CHU, Rabat, Morocco.
Bahji
M
M
Essaadouni
L
L
Agoumi
N  Benkirane
N
Adnaoui
M
M
Tazi
Z Mezalek
ZM
Maaouni
A
A
D000911:Antibodies, Monoclonal / Q000097:blood; D003449:Cryoglobulinemia / Q000097:blood / Q000150:complications*; D006526:Hepatitis C / Q000097:blood / Q000150:complications*; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood*; D007075:Immunoglobulin M / Q000097:blood*; D008297:Male; D008875:Middle Aged
D000911:Antibodies, Monoclonal; D007070:Immunoglobulin A; D007075:Immunoglobulin M