Summary
Thirty-eight patients with essential mixed cryoglobulinemia (EMC: 16 type II and 22 type III) were evaluated. Almost all patients had clinical manifestations which could be related to a cutaneous and/or visceral vasculitic process. No significant clinical or laboratory differences were found between type II and type III EMC patients. Kidney biopsy performed in 9 patients showed membranoproliferative glomerulonephritis in 6 cases, diffuse proliferative glomerulonephritis in 2 cases and mesangioproliferative glomerulonephritis in one case. Skin biopsy performed in 11 patients showed typical leukocytoclastic vasculitis as the most common finding. A picture consistent with overlapping vasculitis was found in 2 cases (one type II and one type III) and thrombus-like deposits were observed in 3 cases (2 type II and one type III). These thrombotic lesions, not associated with vessel wall necrosis and inflammatory infiltrate, were indistinguishable from those observed in one case of type I cryoglobulinemia. Our data emphasize the complexity of blood vessel involvement in cryoglobulinemia and point out the possible existence of multiple pathogenetic mechanisms.
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References
Agnello V., Koffler D., Eisenberg J. W.: Cryoglobulinemia in human renal diseases: a study of 76 cases — Clin. exp. Immunol.15, 483, 1973.
Bartlow B. G., Oyama J. H., Ing T. S., Miller A. W., Economou S. G., Rennie I. D. B., Lewis E. J.: Glomerular ultrastructural abnormalities in a patient with mixed IgG-IgM essential cryoglobulinemic glomerulonephritis — Nephron14, 309, 1975.
Brouet J.-C.: Les cryoglobulinémies — Presse méd.12, 2991, 1983.
Brouet J.-C., Clauvel J.-P., Danon F., Klein M., Seligmann M.: Biologic and clinical significance of cryoglobulins. A report of 86 cases — Amer. J. Med.57, 775, 1974.
Feiner H. D.: Relationship of tissue deposits of cryoglobulins to clinical features of mixed cryoglobulinemia — Hum. Pathol.14, 710, 1983.
Feiner H., Gallo G.: Ultrastructure in glomerulonephritis associated with cryoglobulinemia: a report of 6 cases and review of the literature — Amer. J. Pathol.88, 145, 1977.
Gorevic P. D., Kassab H. J., Levo Y., Kohn R., Meltzer M., Prose P., Franklin E. C.: Mixed cryoglobulinemia. Clinical aspects and long-term follow-up of 40 patients — Amer. J. Med.69, 287, 1980.
Levo Y., Gorevic P. D., Kassab H. J., Zucker-Franklin D., Franklin E. C.: The association between hepatitis B virus and essential mixed cryoglobulinemia — New Engl. J. Med.296, 1501, 1977.
Meltzer M., Franklin E. C.: Cryoglobulinemia. A study of 29 patients. I. IgG and IgM cryoglobulins and factors affecting cryoprecipitability — Amer. J. Med.40, 828, 1966.
Soter N. A., Austen K. F., Gigli I.: The complement system in necrotizing angiitis of the skin. Analysis of complement activities in serum of patients with concomitant collagen-vascular diseases — J. invest. Dermatol.63, 219, 1974.
Tarantino A., Montagnino G.: The pathogenesis of essential cryoglobulinemia. In:Bertani T., Remuzzi G. (Eds): Glomerular injury 300 years after Morgagni. Wichtig ed., Milano, 1983; p. 245.
Vialtel P., Kell D. I., Pinteric L., Dorrington K. J., Klein M.: Nucleation-controlled polymerization of human monoclonal immunoglobulin G cryoglobulins — J. biol. Chem.257, 3811, 1982.
Winfield J. B.: Cryoglobulinemia — Hum. Pathol.14, 350, 1983.
Zanussi C., Invernizzi F., Pioltelli P., Riboldi P. S., Procaccio F., Prandi G., Massaro P.: Essential cryoglobulinaemia. Immunochemical and clinical study in 47 patients — La Ricerca Clin. Lab.8 (Suppl. 1), 21, 1978.
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Cattaneo, R., Fenini, M.G. & Facchetti, F. The cryoglobulinemic vasculitis. La Ricerca Clin. Lab. 16, 327–333 (1986). https://doi.org/10.1007/BF02909357
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DOI: https://doi.org/10.1007/BF02909357