Cryoglobulinemic Vasculitis

Question 1

What are cryoglobulins

Answer 1

Immune complexes that precipitate from serum under conditions of cold

Question 2

Types of Cryoglobulins

Answer 2

Type I: Monoclonal gammopathy (IgG or IgM)
Type II: Mixed cryo (both IgG/IgM)
Type III: Mixed cryo (both IgG/IgM)

Question 3

Type I cryoglobulins

Answer 3

Monoclonal gammopathy (IgG or IgM)

1. Multiple Myeloma
2. Waldestrom Macroglobulinemia

Question 4

Type II cryoglobulins

Answer 4

Mixed cryo (both IgG/IgM):
1. Hepatitis C (polyclonal IgG and monoclonal IgM)

Question 5

Type III cryoglobulins

Answer 5

Mixed cryo (both IgG/IgM):
Polyclonal IgG and polyclonal IgM
Triad: Arthralgia, Purpura and Myalgia

Question 6

Type I cryoglobulins presentation

Answer 6

Presentation: Hyperviscosity syndrome

Dizziness, Confusion, Headache, Stroke

Question 7

Type II/III cryoglobulins presentation

Answer 7

Triad: Arthralgia, Purpura and Myalgia
More common Type II:
Membranoproliferative GN
Peripheral Neuropathy
Cutaneous Ulceration

Question 8

Labs in cryoglobulinemia

Answer 8

+cryoglobulin
Low C4 (out of proportion to C3)
+RF
High ESR/CRP