Cryoglobulinaemia

A medical condition in which the blood contains large amounts of cryoglobulins.

Etiology:

  1. clonal B-cell abnormalities
  2. blood cancers such as multiple myeloma
  3. hepatitis C infection.

Manifestations:

  1. blood vessel inflammation
  2. increased blood viscosity

 Immunology and biochemistry:

Cryoglobulins –

  • are a type of immunoglobulins, a type of gamma globulin.
  • cryoglobulin – zre an abnormal blood protein that has the unusual properties of precipitating from the blood serum when it is chilled (hence the “cryo-“) and redissolving when it is rewarmed.
  • Cryoglobulins congeal or gel at cold temperatures.
  • These proteins are made by B lymphocytes or their derivative cells, plasma cells.

 

Three types of cryoglobinemia:

Type I isolated monoclonal immunoglobulins 10-15% of the total cases These are composed of a single monoclonal immunoglobulin paraprotein (usually IgM). Sometimes, these are represented by light chains only and can be extracted from the urine, or they will accumulate in blood serum in the event of renal failure.[5]
Type II immunocomplexes formed by monoclonal IgM 50-60% of reported cases They usually have a polyclonal component, usually IgG, and a monoclonal component, usually IgM, which has an RF function. The IgM can recognize intact IgG or either the Fab region or Fc region of IgG fragments. This is why most type II cryoglobulins are IgM-IgG complexes.[5]
Type III immunocomplexes formed by polyclonal IgM 25-30% of the reported cases These have very similar function to the type II cryoglobulins, however they are composed for polyclonal IgM and IgG molecules
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