title: Cryoglobulinaemia and rapidly deteriorating renal function in chronic lymphocytic leukaemia.
abstract: Cryoglobulinaemia is a rare condition characterized by serum immunoglobulins or immunocomplexes which precipitate at temperatures below 37 °C and redissolve on warming. Cryoglobulinaemic vasculitis develops in ~ 15% of patients positive for cryoglobulin serology and is often associated with an underlying infectious, autoimmune or lymphoproliferative disease. We describe a case of cryoglobulinaemic vasculitis, which manifested as purpura and rapidly deteriorating renal function in a patient with chronic lymphocytic leukaemia and coexistent parvovirus infection. This case illustrates the complex pathophysiology of cryoglobulinaemic renal injury, and suggests that infection may serve as a trigger in the presence of other pathophysiological factors.
authors.affiliation: Department of Renal Unit of Internal Medicine, Hachioji Medical Center of Tokyo Medical University, 1163 Tate-machi, Hachioji-shi, Tokyo 193-0998, Japan.
authors.forename: Anna-Kaisa
authors.initials: AK
authors.lastname: Purhonen
authors.forename: Maija
authors.initials: M
authors.lastname: Mikkola
authors.forename: Leena
authors.initials: L
authors.lastname: Karjalainen
authors.forename: Markku
authors.initials: M
authors.lastname: Helle
authors.forename: Anne
authors.initials: A
authors.lastname: Lumiaho
authors.forename: Auni
authors.initials: A
authors.lastname: Juutilainen
mesh_terms: D000368:Aged; D003449:Cryoglobulinemia / Q000150:complications* / Q000382:microbiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology*; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications* / Q000382:microbiology; D008297:Male; D010321:Parvoviridae / Q000302:isolation & purification; D010322:Parvoviridae Infections / Q000209:etiology*; D011379:Prognosis; D011693:Purpura / Q000209:etiology*; D014657:Vasculitis / Q000150:complications* / Q000382:microbiology