title: The Presence of Some Humoral Immunologic Indicators and Clinical Manifestations in Cryoglobulin Positive Heroin Addicts without Evidence of Hepatitis Virus Infection.
abstract: BACKGROUND
  Cryoglobulins are single or mixed immunoglobulins that are subject to reversible precipitation at low temperatures.
  
  
  OBJECTIVE
  The aims of this paper were: 1. Comparison of cryoglobulin positive (CP), cryoglobulin negative (CN) heroin addicts and the control group (CG) in terms of serum immunoglobulins IgG, IgA and IgM and complement components C3 and C4; 2. Comparison of CP and CN heroin addicts in terms of rheumatoid factor (RF) and circulating immune complexes (CIC); 3. Assessment of clinical manifestations in CP heroin addicts.
  
  
  METHODS
  This is a comparative study of cases (outpatients) treated at the University Clinic of Toxicology in Skopje over 3.5 years, from January 2009 to June 2012. In this study 140 heroin addicts without HbsAg were examined, seronegative for HCV and HIV infections.They were divided into 2 groups: 70 CP and 70 CN heroin addicts. A previously designed self-administered questionnaire was used as a data source on participants. All heroin addicts underwent the following analyses: urea and creatinine in serum; creatinine in urine; proteinuria; 24-hour proteinuria; IgM, IgG, IgA, C3, C4; RF; CIC; creatinine clearance; ECG; toxicological analyses for opioids in a urine sample; cryoglobulins. In addition to these 2 groups, IgG, IgA, IgM, C3 and C4 were also examined in 70 healthy subjects (CG).
  
  
  RESULTS
  The study showed that there was no statistically significant difference between CP, CN heroin addicts and CG regarding the concentration of IgA, IgG, IgM, C3 and C4, and between CP and CN regarding the concentration of CIC. There was significant difference between CP and CN regarding the concentration of RF. The following conditions were significantly more frequently manifested in CP than in CN heroin addicts: arthralgia, Raynaud's phenomenon, respiratory difficulties, neurological disorders, manifested skin changes, hematuria, 24-hour proteinuria levels, and decreased renal clearance.
  
  
  CONCLUSIONS
  There were no differences in concentrations of IgG, IgA, IgM, C3, C4 and CIC, while there was a difference in concentration of RF between CP and CN heroin addicts. Clinical manifestations (arthralgias, Raynaud's phenomenon, respiratory, neurologic, renal disorders and skin changes) were more common in CP heroin addicts.
authors.forename: Natasha
authors.initials: N
authors.lastname: Simonovska
authors.forename: Andon
authors.initials: A
authors.lastname: Chibishev
authors.forename: Cvetanka
authors.initials: C
authors.lastname: Bozinovskal
authors.forename: Ladislava
authors.initials: L
authors.lastname: Grchevska
authors.forename: Kocho
authors.initials: K
authors.lastname: Dimitrovskil
authors.forename: Violeta
authors.initials: V
authors.lastname: Neceva
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000032:analysis* / Q000097:blood / Q000276:immunology* / Q000652:urine; D003449:Cryoglobulinemia / Q000097:blood; D003450:Cryoglobulins / Q000032:analysis*; D005260:Female; D006518:Hepatitis Viruses / Q000276:immunology; D006556:Heroin Dependence / Q000097:blood / Q000276:immunology* / Q000652:urine; D006801:Humans; D056724:Immunity, Humoral; D007159:Immunologic Tests; D008297:Male; D008875:Middle Aged
chemical_list: D001323:Autoantibodies; D003450:Cryoglobulins