Cryogloblulinemia

Etiology

  • Medium-vessel vasculitis caused by antigen-antibody complex deposition
  • Type I monoclonal→ IgM or IgG related to lymphoprolif d/o→ lymphoma, myeloma
  • Type II and III, mixed cryos IgM and IgG related to Hep C (most common), SLE, RA, lymphoma, myeloma, HIV, hep b, other autoimmune
  • Affects multiple systems (nerves, lungs, kidneys, etc.)

Risk Factors

  • Female > Male
  • Ages 40-50

Symptoms

  • Weakness
  • Confusion
  • Subacute fatigue
  • Muscle and joint aches
  • Cough/sob if pulmonary involvement
  • Symmetric or asymmetric often painful distal neuropathy
  • Painful skin ulcers of extremities
  • Purpuric papules
  • Membranoproliferative glomerulonephritis

Physical Exam Findings

  • Raynauds
  • Palpable purpura of vasculitis
  • Livedo reticularis
  • Distal skin ulcers
  • Peripheral neuropathy related: decreased distal sensation, weakness, diminished reflexes

Tests

Links