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Life-threatening cryoglobulinemia in HCV-negative Southern Chinese and a novel association with structural aortic abnormalities

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Abstract

Cryoglobulinemia is uncommon in Southern Chinese in Hong Kong, with tropical climates and low incidence of hepatitis C virus (HCV) infection. Eight positive cases were detected among 481 patients screened for cryoglobulins over a 10-year period. Three HCV carriers (38%) ran benign courses. The others included two carriers of hepatitis B virus (HBV), two patients with adenocarcinoma, and one with chronic lymphocytic lymphoma. Four of them (except one HBV carrier) ran fulminant courses and died of cryoglobulin-related complications. Interestingly, all four cases also had structural aortic abnormalities, including multiple dissections, aneurysms, and congenital aortic arch abnormalities, which were often life threatening. The association of aortic abnormality and cryoglobulinemia is hitherto unreported and may be peculiar to our ethnic group. Aggressive control of the cryoglobulin may help to reduce aortic intima damage.

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References

  1. Gorevic PD, Kassab HJ, Levo Y, Kohn R, Meltzer M, Prose P et al (1980) Mixed cryoglobulinemia: clinical aspects and long-term follow-up of 40 patients. Am J Med 69:287–308

    Article  CAS  PubMed  Google Scholar 

  2. Fohlen-Walter A, Jacob C, Lecompte T, Lesesve JF (2002) Laboratory identification of cryoglobulinemia from automated blood cell counts, fresh blood samples, and blood films. Am J Clin Pathol 117:606–614

    Article  PubMed  Google Scholar 

  3. Dammacco F, Sansonno D, Piccoli C, Tucci FA, Racanelli V (2001) The cryoglobulins: an overview. Eur J Clin Invest 31:628–638

    Article  CAS  PubMed  Google Scholar 

  4. Okuse C, Yotsuyanagi H, Okazaki T, Yasuda K, Fujioka T, Tomoe M et al (2003) Detection, using a novel method, of a high prevalence of cryoglobulinemia in persistent hepatitis C virus infection. Hepatol Res 27:18–22

    Article  CAS  Google Scholar 

  5. Vithayasai P, Rungruangtanakit K, Vithayasai V (1989) First report case of cryoglobulinemia and cryofibrinogenemia in Thailand. J Med Assoc Thai 72:536–540

    CAS  PubMed  Google Scholar 

  6. Gad A, Tanaka E, Matsumoto A, el-Hamid Serwah A, Ali K, Makledy F et al (2003) Factors predisposing to the occurrence of cryoglobulinemia in two cohorts of Egyptian and Japanese patients with chronic hepatitis C infection: ethnic and genotypic influence. J Med Virol 70:594–599

    Article  PubMed  Google Scholar 

  7. Wu MJ, Lan JL, Shu KH, Cheng CH, Chen CH, Lian JD (2000) Prevalence of subclinical cryoglobulinemia in maintenance hemodialysis patients and kidney transplant recipients. Am J Kidney Dis 35:52–57

    CAS  PubMed  Google Scholar 

  8. Levo Y, Gorevic PD, Kassab HJ, Zucker-Franklin D, Franklin EC (1977) Association between hepatitis B virus and essential mixed cryoglobulinemia. N Engl J Med 296:1501–1504

    CAS  PubMed  Google Scholar 

  9. Galli M, Monti G, Invernizzi F, Monteverde A, Bombardieri S, Gabrielli A et al (1992) Hepatitis B virus-related markers in secondary and in essential mixed cryoglobulinemias: a multicentric study of 596 cases. The Italian Group for the Study of Cryoglobulinemias (GISC). Ann Ital Med Int 7:209–214

    CAS  PubMed  Google Scholar 

  10. Invernizzi F, Galli M, Serino G, Monti G, Meroni PL, Granatieri C et al (1983) Secondary and essential cryoglobulinemias. Frequency, nosological classification, and long-term follow-up. Acta Haematol 70:73–82

    CAS  PubMed  Google Scholar 

  11. Krunic AL, Medenica MM, Laumann AE, Shaw JC (2003) Cryoglobulinaemic vasculitis, cryofibrinogenaemia and low-grade B-cell lymphoma. Br J Dermatol 148:1079–1081

    CAS  PubMed  Google Scholar 

  12. Kwong YL, Wong KF, Chan LC, Liang RH, Chan JK, Wei D et al (1994) The spectrum of chronic lymphoproliferative disorders in Chinese people. An analysis of 64 cases. Cancer 74:174–181

    CAS  PubMed  Google Scholar 

  13. Singer DR, Venning MC, Lockwood CM, Pusey CD (1986) Cryoglobulinaemia: clinical features and response to treatment. Ann Med Interne (Paris) 137:251–253

    CAS  Google Scholar 

  14. Wang HC, Lu JY, Ting YM, Lin CC (1996) Digital ischemia associated with lung cancer: a case report. Zhonghua Yi Xue Za Zhi (Taipei) 57:370–374

    CAS  Google Scholar 

  15. Seth P, Balachandran N, Malaviya AN, Kumar R (1979) Circulating immune complexes in carcinoma of uterine cervix. Clin Exp Immunol 38:77–82

    CAS  PubMed  Google Scholar 

  16. Akriviadis EA, Xanthakis I, Navrozidou C, Papadopoulos A (1997) Prevalence of cryoglobulinemia in chronic hepatitis C virus infection and response to treatment with interferon-alpha. J Clin Gastroenterol 25:612–618

    Article  CAS  PubMed  Google Scholar 

  17. Herold BC, Davis AT, Arroyave CM, Duffy E, Pachman LM, Shulman ST (1988) Cryoprecipitates in Kawasaki syndrome: association with coronary artery aneurysms. Pediatr Infect Dis J 7:255–257

    CAS  PubMed  Google Scholar 

  18. Dabala A, Musso L, Oreste PL, Scaccabarozzi U, Scarpini S, Grigolato PG et al (1986) Antiapolipoprotein B cryoglobulinemia associated with normal plasma lipids and severe atherosclerosis. Appl Pathol 4:260–269

    CAS  PubMed  Google Scholar 

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Correspondence to Wing Y Au.

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Au, W.Y., Kwok, J.S.Y., Chu, K.M. et al. Life-threatening cryoglobulinemia in HCV-negative Southern Chinese and a novel association with structural aortic abnormalities. Ann Hematol 84, 95–98 (2005). https://doi.org/10.1007/s00277-004-0955-7

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  • DOI: https://doi.org/10.1007/s00277-004-0955-7

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