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Cryoglobulin

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https://www.readbyqxmd.com/read/29739081/subclasses-of-monoclonal-type-i-immunoglobulin-g-cryoglobulins-report-on-two-distinct-cases-with-myeloma
#1
Tania Petersen, Sebastien Riviere, Stephanie Malbos, Yannick Chantran, Aicha Abbas, Francois Chasset, Arsene Mekinian, Jeremie Sellam, Laurent Garderet, Pierre Aucouturier
BACKGROUND: While different clinical manifestations of IgM and IgG monoclonal cryoglobulins have been demonstrated, little is known about the roles of IgG subclasses in the pathophysiology of these conditions. METHODS: In two cases of myeloma-associated monoclonal (type I) cryoglobulinemia with quite distinct clinical and biological features, serum samples were analyzed using an original IgG subclass-specific immunoblotting technique. RESULTS: The first case had painful arthritis of hands and feet, with skin purpura and a sharp decrease of complement C4 level, and the cryoglobulin was of IgG1 subclass...
April 1, 2018: Clinical Laboratory
https://www.readbyqxmd.com/read/29734473/treatment-for-hepatitis-c-virus-associated-mixed-cryoglobulinaemia
#2
REVIEW
Nuria Montero, Alexandre Favà, Eva Rodriguez, Clara Barrios, Josep M Cruzado, Julio Pascual, Maria Jose Soler
BACKGROUND: Hepatitis C virus (HCV)-associated mixed cryoglobulinaemia is the manifestation of an inflammation of small and medium-sized vessels produced by a pathogenic IgM with rheumatoid factor activity generated by an expansion of B-cells. The immune complexes formed precipitate mainly in the skin, joints, kidneys or peripheral nerve fibres. Current therapeutic approaches are aimed at elimination of HCV infection, removal of cryoglobulins and also of the B-cell clonal expansions. The optimal treatment for it has not been established...
May 7, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29729982/c3-glomerulopathy-associated-with-monoclonal-ig-is-a-distinct-subtype
#3
Aishwarya Ravindran, Fernando C Fervenza, Richard J H Smith, Sanjeev Sethi
Monoclonal immunoglobulins (MIg) may play a causal role in C3 glomerulopathy (C3G) by impairing regulation of the alternative pathway of complement. Ninety-five patients with C3G were tested for MIg of which 36 were positive. Their mean age at diagnosis was 60 years and among patient 50 years and older, 65.1% had a MIg. At presentation, median serum creatinine and proteinuria were 1.9 mg/dL and 3.0 g/24 hours. Hematuria was present in 32 (88.9%) patients. Twelve (34.3%) patients had low C3 levels. C3 nephritic factor was detected in 45...
May 2, 2018: Kidney International
https://www.readbyqxmd.com/read/29709461/different-biochemical-patterns-in-type-ii-and-type-iii-mixed-cryoglobulinemia-in-hcv-positive-patients
#4
Umberto Basile, Francesca Gulli, Laura Gragnani, Krizia Pocino, Cecilia Napodano, Luca Miele, Stefano Angelo Santini, Mariapaola Marino, Anna Linda Zignego, Gian Ludovico Rapaccini
BACKGROUND: Reversible cryoprecipitability of proteins is observed as a concomitant feature of immune complex formation. Mixed cryoglobulinemia (MC) is systemic vasculitis, associated with mixed IgM and IgG cryoglobulins (CGs) showing rheumatoid factor (RF) activity. It is frequently associated with hepatitis C virus (HCV). This study investigates the presence of IgG RF and anti-nuclear antibodies (ANA) in cryoprecipitates of patients with type III and type II MC, to understand the biochemical patterns associated with different types of MC to a greater degree...
April 4, 2018: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29705529/long-term-outcomes-of-patients-with-hcv-associated-cryoglobulinemic-vasculitis-after-virologic-cure
#5
Martín Bonacci, Sabela Lens, Zoe Mariño, María-Carlota Londoño, Sergio Rodriguez-Tajes, José M Sánchez-Tapias, Manel Ramos-Casals, José Hernández-Rodríguez, Xavier Forns
Patients with hepatitis C virus-associated cryoglobulinemic vasculitis (HCV-CV) have high rates of clinical remission after treatment with direct-acting antivirals (DAAs),but circulating cryoglobulins persist and vascular disorders reappear in some patients shortly after DAA treatment ends. We performed a prospective study to assess the long-term clinical and immune system effects of HCV eradication with DAAs in 46 patients with HCV-CV and 42 asymptomatic patients with circulating cryoglobulins. A median of 24 months after DAA treatment (range, 17-41 months), 66% of patients with HCV-CV and 70% of asymptomatic patients with circulating cryoglobulins had immunologic response, with comparable reductions in cryocrit from 2...
April 26, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29697211/molecular-profiling-and-clonal-tracking-of-secreted-rheumatoid-factors-in-primary-sj%C3%A3-gren-s-syndrome
#6
Jing J Wang, Joanne H Reed, Alex D Colella, Amanda J Russell, William Murray-Brown, Tim K Chataway, Katherine J L Jackson, Christopher C Goodnow, Tom P Gordon
OBJECTIVE: Rheumatoid factors (RFs) are associated with systemic disease in primary Sjögren's syndrome (SS) and may be pathogenic as mixed cryoglobulins. Current detection methods cannot resolve RFs at a molecular level. Here, we perform the first proteomic and transcriptomic analysis of secreted and membrane-bound RF IgM in primary SS and identify unique heavy (H)-chain peptide signatures for RF clonotype tracking. METHODS: Purified H-chains of serum RFs (IgH-RF) from 15 primary SS patients were subjected to de novo mass spectrometric sequencing...
April 26, 2018: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/29694729/treatment-of-hepatitis-c-virus-infection-in-patients-with-mixed-cryoglobulinemic-syndrome-and-cryoglobulinemic-glomerulonephritis
#7
REVIEW
Stephanie M Rutledge, Raymond T Chung, Meghan E Sise
Cryoglobulinemia is a common extrahepatic manifestation of infection with hepatitis C virus (HCV). When signs and symptoms of systemic vasculitis or glomerulonephritis occur in the presence of circulating cryoglobulins, this syndrome is called "mixed cryoglobulinemia syndrome" (MCS). Historically, interferon-based therapies in HCV have been associated with lower rates of viral cure in patients with MCS than in the general HCV-infected population. The advent of direct-acting antiviral therapies have revolutionized the treatment of HCV, dramatically increasing rates of cure...
April 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29669392/ectopic-germinal-centre-like-structures-in-minor-salivary-gland-biopsy-predict-lymphoma-occurrence-in-patients-with-primary-sj%C3%A3-gren-syndrome
#8
Damien Sène, Sophie Ismael, Marine Forien, Frédéric Charlotte, Rachid Kaci, Patrice Cacoub, Diallo Abdourahmane, Philippe Dieudé, Frédéric Lioté
OBJECTIVE: The objective was to determine risk factors of pSS-associated lymphoma in a multicenter cohort of patients, including in analyzed variables the presence of including ectopic germinal centre-like structures in minor salivary gland biopsy (MSGB). PATIENTS AND METHODS: 115 pSS-patients were included and their MSGB were retrospectively examined focusing on the presence of ectopic germinal centre-like structures. Epidemiological, clinical, biological, immunological and histological data were collected at pSS diagnosis...
April 18, 2018: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/29595085/immunosuppressive-and-antiviral-treatment-of-hepatitis-c-virus-associated-glomerular-disease-a-long-term-follow-up
#9
Fabrizio Fabrizi, Alessio Aghemo, Pietro Lampertico, Mirella Fraquelli, Donata Cresseri, Gabriella Moroni, Patrizia Passerini, Francesca M Donato, Piergiorgio Messa
BACKGROUND: The evidence in the medical literature on the treatment of hepatitis C virus-associated glomerular disease is extremely limited. The advent of nonconventional immunosuppressive agents and direct-acting antivirals promises high efficacy and safety. AIMS: We conducted an open-label, single-arm clinical study to examine the efficacy and safety of a combined approach for hepatitis C virus-associated glomerular disease. METHODS: In the first phase of the study, patients with hepatitis C virus-associated glomerular disease received interferon-based antiviral therapy and immunosuppressive agents; since 2013, interferon-free antiviral therapy was adopted and novel immunosuppressants (including B-cell depleting agents and mycophenolate mofetil) or immunomodulators (ribavirin) were choiced...
March 1, 2018: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29579860/initial-experience-in-the-use-of-novel-auto-expandable-metal-ureteral-stent-in-the-treatment-of-ureter-stenosis-in-kidney-transplanted-patients
#10
J J Salamanca-Bustos, E Gomez-Gomez, J P Campos-Hernández, J Carrasco-Valiente, J Ruiz-García, F J Márquez-López, L Zurera-Tendero, M J Requena-Tapia
INTRODUCTION: Ureter stenosis in renal transplantation patients is a relatively frequent complication that negatively conditions graft evolution. The use of ureteral stents is a valid treatment alternative to the use of double-J catheters in patients for whom surgery is not contemplated or after surgical recurrence. We present our initial experience with five patients treated using this technique. MATERIALS AND METHODS: We describe a total of five patients with ureteral stenosis after renal transplantation who were treated using ureteral stent model UVENTA (Taewoong Medical, Seoul, Korea) in our center...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29560002/a-rare-case-of-eosinophilic-granulomatosis-with-polyangiitis-associated-with-cryoglobulinemia-presenting-with-a-bullous-skin-eruption-of-the-lower-limbs
#11
D D K Abeyaratne, C Liyanapathirana, C L Fonseka, P W M C S B Wijekoon
Background: Eosinophilic granulomatosis with polyangiitis (EGPA) is an antineutrophil cytoplasmic antibody- (ANCA-) associated small vessel vasculitis with multisystem involvement. It is characterized with asthma, eosinophilia, and renal and peripheral nervous system involvement. However, EGPA presenting with bullous skin eruption is an uncommon dermatological manifestation. We report a rare case of EGPA overlapped with mixed essential cryoglobulinemia presenting with a bullous skin eruption...
2018: Case Reports in Medicine
https://www.readbyqxmd.com/read/29558353/-cryoglobulins-and-cryoglobulinemic-vasculitis
#12
Dorota Suszek, Maria Majdan
Cryoglobulinemia is defined as the presence of cryoglobulins in the blood. Cryoglobulinemia is often observed in the course of many diseases (infection, hematological disorders, autoimmune disorders) or has an idiopathic character. The classification of cryoglobulinemia is based on the immunological analysis of cryoglobulins and the activity of the rheumatoid factor (RF). The presence of cryoglobulins may induce cryoglobulinemic vasculitis (CV) which manifests with skin changes, arthritis and the dysfunction of internal organs...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29545130/-renal-involvement-of-cryoglobulinemia
#13
Alexandre Karras
Cryoglobulins are immunoglobulins that undergo reversible precipitation at low temperatures. They can induce systemic vasculitis, characterized by purpuric cutaneous lesions, arthritis, peripheral neuropathy, hypocomplementemia and glomerular disease. Renal pathology reveals membranoproliferative glomerulonephritis, with particularly intense mesangial cell proliferation and infiltration by macrophages, associated with intracapillary thrombi. This renal disease presents as a nephritic syndrome, with heavy proteinuria, haematuria severe hypertension and rapidly progressive kidney failure that can lead to end-stage renal disease...
April 2018: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29526627/cryoglobulins-an-update-on-detection-mechanisms-and-clinical-contribution
#14
REVIEW
Marie-Nathalie Kolopp-Sarda, Pierre Miossec
Cryoglobulins are immunoglobulins precipitating in cold condition. They are classified in 3 types according to the Brouet classification and may lead to vasculitis of small and medium size vessels. Vasculitis is related to vessel obstruction by monoclonal cryoglobulin aggregates in type I cryoglobulins and immune complex deposition in type II and III mixed cryoglobulins. This phenomenon is favored by low temperature, especially in skin, joints, and peripheral nerves, or increased cryoglobulin concentration in kidneys...
May 2018: Autoimmunity Reviews
https://www.readbyqxmd.com/read/29469770/interstitial-granulomatous-dermatitis-in-a-patient-with-chronic-hepatitis-c-and-mixed-cryoglobulinemia
#15
M Rato, F Gil, A F Monteiro, J Aranha, E Tavares
A 55-year-old man presented with a history of asymptomatic, bilateral, figurate dermatosis consisting of erythematous, annular, linear, andarciform, indurated nodules and plaques on the lateral walls of thorax, flanks, and hypogastrium. His medical history was positive for chronic hepatitis C. Skin biopsy was compatible with the diagnosisof interstitial granulomatous dermatitis. Additionalinvestigation revealed positive rheumatoid factor, antinuclear antibodies, and cryoglobulins. Thepatient started treatment with high-potency topical corticosteroid...
January 15, 2018: Dermatology Online Journal
https://www.readbyqxmd.com/read/29433114/-hepatitis-c-virus-induced-cryoglobulinemic-vasculitis
#16
Yasunori Minami, Masatoshi Kudo
Cryoglobulins are produced by the over-stimulated immune system of patients with hepatitis C virus (HCV). HCV-induced cryoglobulinemic vasculitis primarily affects small-sized vessels of systemic organs. The most common symptoms are purpura, joint pain, and peripheral neuropathy or Raynaud phenomenon. The blood tests of patients with HCV may exhibit raised erythrocyte sedimentation rate and C-reactive protein levels, positive rheumatoid factor and cryoglobulins, and decreased complement levels. Therapeutic options for HCV-induced cryoglobulinemic vasculitis, include anti-virals, Rituximab, steroids, immunosuppressant drugs, and plasma exchange...
February 2018: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/29395708/successful-treatment-of-type-1-cryoglobulinemic-vasculitis-with-cardiac-involvement
#17
Xin-Xin Cao, Zhuang Tian, Lu Lin, Jian Sun, Wei Su, Dao-Bin Zhou, Jian Li
Cryoglobulinemic vasculitis is a rare and frequently fatal type of myocarditis. Cardiac manifestations in type 1 cryoglobulinemic vasculitis have never been reported to our knowledge. We report a rare case of type 1 cryoglobulinemic vasculitis with cardiac involvement in a patient who experienced progressive heart failure during the diagnosis. The diagnosis was made by the presence of cryoglobulins and endomyocardial biopsy results. After bortezomib-containing treatments, plasma cryoglobulin levels returned to normal, and the patient's clinical condition gradually improved...
March 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29370761/hepatitis-c-related-cryoglobulinemic-neuropathy-potential-role-of-oxcarbazepine-for-pain-control
#18
Rita Moretti, Paola Caruso, Matteo Dal Ben, Silvia Gazzin, Claudio Tiribelli
BACKGROUND: Peripheral neuropathy is one most common, limiting and invalidating neurological symptom in subjects with hepatitis C virus and mixed cryoglobulinemia. Notably, the medical therapy proposed to eradicate HCV, can frequently exacerbate the painful neuropathy. Therefore, neuropathy therapies are insufficient and inadequate, and comprise immunosuppressive drugs, such as steroid or cyclosporine, intravenous immunoglobulin or plasma exchange. These have shown variable success in case reports, with a presumably temporary effect, but with major side effects...
January 25, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29162217/atypical-case-of-classical-polyarteritis-nodosa-alveolar-hemorrhage-and-positive-antineutrophil-cytoplasmic-antibody
#19
Nicole A Sitkin, Ethan Bernstein, Mark A Perazella
Classical polyarteritis nodosa (PAN) is a necrotizing arteritis affecting medium-sized vessels. A 73-year-old gentleman who presented with progressive anemia and scant hemoptysis developed acute kidney injury over the course of hospital admission. Kidney biopsy was initially interpreted as consistent with cephalosporin-associated acute interstitial nephritis (AIN) and acute tubular injury (ATI). After oral prednisone (5 days), the patient was discharged with improving serum creatinine. Two days later, he presented with diffuse alveolar hemorrhage...
January 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29114186/clinical-utility-of-anti-c1q-antibody-in-primary-and-secondary-vasculitic-conditions
#20
Kabeerdoss Jayakanthan, And Nikhil Gupta, John Mathew, Raheesh Ravindran, Gowri Mahasampth, Debashish Danda
Objective: Anti-C1q antibodies (Anti-C1q Ab) are seen in hypocomplementemic urticarial vasculitis syndrome (HUVS), infection-associated vasculitis such as hepatitis C virus-related vasculitis and in autoimmune diseases such as rheumatoid vasculitis, polyarteritis nodosa, giant cell arteritis, vascular Behcet's disease, and cryoglobulin associated vasculitis. Aim of this study is to evaluate the presence of Anti-C1q Ab in vasculitis and to determine if any difference exists between primary and secondary vasculitis in relation to this antibody...
November 2017: International Journal of Health Sciences
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