Cold hard facts of cryoglobulinemia: updates on clinical features and treatment advances.
Cryoglobulins are immunoglobulins that precipitate at temperatures less than 37°C. They occur secondary to infectious, autoimmune, and malignant processes. In the Brouet classification, type I cryoglobulinemia is caused by hyperviscosity, whereas type II and III manifestations are caused by vasculitis in target organs (primarily skin, peripheral nerves, and kidney). New classification criteria were recently proposed that may help with study and treatment of cryoglobulinemic vasculitis (CryoVas). Hepatitis C virus is the most common cause of CryoVas and treatment with antivirals can be curative in mild cases, whereas rituximab is highly effective in treating active vasculitis in more severe cases.
Division of Arthritis & Rheumatic Diseases, Vasculitis Center, Oregon Health & Science University, Portland, OR, USA.
Daniela
D
Ghetie
Division of Arthritis & Rheumatic Diseases, Vasculitis Center, Oregon Health & Science University, Portland, OR, USA.
Navid
N
Mehraban
Division of Arthritis & Rheumatic Diseases, Vasculitis Center, Oregon Health & Science University, Portland, OR, USA. Electronic address: sibleyc@ohsu.edu.
Cailin H
CH
Sibley
D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D003449:Cryoglobulinemia / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D000069283:Rituximab
D058846:Antibodies, Monoclonal, Murine-Derived; D018501:Antirheumatic Agents; D000069283:Rituximab
Cryoglobulinemia; Cryoglobulinemic; Diagnosis; HCV; Rituximab; Treatment; Vasculitis