Crioglobulinemia

Hepatitis C virus (HCV) infection has been associated as up 40-70% of patients with extrahepatic manifestations (EHM) and 36 different syndromes. These could be attributed to the fact that HCV is lymphotropic, particularly B lymphotropic, and not merely hepatotropic, and could trigger immunological alterations indirectly by exerting a chronic stimulus on the immune system with production of immunoglobulins having rheumatoid activity forming immune complexes and production of cryoglobulins. Cryoglobulinemoa plays a pivotal role in producing most EHM of HCV such as vasculitis, glomerulonephritis, arthritis and neuropathies...

In 1933, the Swedish ophthalmologist Hendrik Sjögren was the first to suggest that behind the dryness that several of his patients presented, there could be a systemic disease related to an abnormal immune response. Since then, the term Sjögren's syndrome (SjS) has been used and it has been considered a minor and infrequent disorder compared to other systemic autoimmune diseases (SAD) and, consequently, with little progress both in clinical and therapeutic research. The emergence of new technologies at the end of the 20th century rapidly promoted the development of international projects of great impact and diffusion, which have completely changed this scenario, and in the last 20 years significant progress has been made in understanding the main epidemiological determinants and pathogenic mechanisms to increase the diagnostic accuracy and to design specific and individualized therapeutic strategies...

The cryoglobulinemic syndrome is produced by precipitating immunoglobulins at low temperatures. Its production is associated with several causes, such as lymphoproliferative disorders, chronic infections and autoimmune disorders. However, the etiology is unknow. There are three types of cryoglobulins. Type II and III are the mixed. Type III produce a systemic vasculitis with diverse clinical manifestations. Palpable purpura is the most common, accompanied by arthralgia, neuropathy and type I membranoproliferative glomerulonephritis...

The study of 304 patients with chronic hepatitis C is presented. It was shown that in patients with chronic hepatitis C the occurrence and increase of violations of a functional condition of vegetative nervous system it is combined with emergence and progressing of signs of the mixed cryoglobulinemia. Clinical demonstration of the HCV associated crioglobulinemia syndrome is accompanied by the most expressed vegetative dysfunction, the being characterized low capacity of variability of a rhythm of heart and development of a vegetative disbalance and sympathicotonia...

The study of 78 patients with chronic hepatitis C is presented. It was found that emergence and progression of endothelium-dependent dysfunction of endothelium is combined with progression of liver fibrosis. The manifestation of clinical signs of the HCV-associated crioglobulinemia syndrome is registered in patients with stage F 3-4 liver fibrosis against the background of high concentration of the mixed cryoglobulins, rheumatoid factor of Ig M and the expressed endothelium-dependent dysfunction of endothelium...

Forty-seven patients: group A--17 patients with acute ischemic atherothrombotic stroke and group B--30 patients with acute Q-formation myocardial infarction. The levels of dynamics and comparative clinical relevance of crioglobulinemia in patients of the both groups have been evaluated. Crioglobulines (CG) in the peripheral blood serum were determined at 1, 2, 3, 7th and 14th days after the disease development. On the 1st day, the elevated CG level similar in the both groups as well as similarity of crioglobulinemia dynamics in whole was observed...

Tubulo interstitial nephritis, the main manifestation of renal involvement in Sjögren syndrome, may lead to a tubular dysfunction that is usually subclinical. We report three women, aged 32, 35 and 35 years old, with a primary Sjögren syndrome and symptomatic type I or distal tubular acidosis. Two patients had nephrolithiasis and one a nephrocalcinosis. Two had a basal hyperchloremic metabolic acidosis. The ammonium chloride acidification test was abnormal in all, demonstrating a distal tubular defect...

In recent years recombinant alpha interferon (IFN) has been widely used in the treatment of neoplastic and infectious diseases. Induced autoimmune disorders and thyroid impairment are getting increasing relevance in the field of side-effects complicating long-term alpha-interferon courses. We monitored thyroid function in 35 patients receiving alpha-IFN therapy for different diseases (chronic hepatitis, essential thrombocytemia, multiple myeloma, chronic myeloid leukemia, essential polycytemia, essential crioglobulinemia and hairy-cell leukemia)...

Some aspects of the diffuse proliferative glomerulonephritis have been examined: initial renal failure, evolution of the lesions, crioglobulinemia. Thirty-five of 88 cases presented high urea levels, in 3 of them with acute renal failure transient hemodialysis treatment was needed, only one case progressed toward chronic renal failure. Anatomic alterations either in the case of exudative or proliferative damages improved but not up to complete healing: mesangial tickening and local proliferation has been observed...