Abstract
Primary mixed cryoglobulinaemia was diagnosed in a 65-year-old woman and confirmed on post-mortem examination. The patient had the classical findings of purpura, arthralgia, renal failure, mixed cryoglobulins in the serum and rheumatoid factor activity. The patient presented with haemolytic anaemia and later developed rectal bleeding, but the most prominent feature was an acute psychosis with electroencephalographic changes, that was attributed to the disease and responded well to corticosteroids. Primary mixed cryoglobulinaemia should be included in the differential diagnosis of central nervous system involvement in systemic connective tissue diseases. This complication should not be missed since it seems to respond well to corticosteroids and/or to plasmapheresis if diagnosed in time.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Berkman E. M., Orlin J. B. Use of plasmapheresis and partial plasma exchange in the management of patients with cryoglobulinemia. Transfusion. 1980 Mar-Apr;20(2):171–178. doi: 10.1046/j.1537-2995.1980.20280169957.x. [DOI] [PubMed] [Google Scholar]
- Brouet J. C., Clauvel J. P., Danon F., Klein M., Seligmann M. Biologic and clinical significance of cryoglobulins. A report of 86 cases. Am J Med. 1974 Nov;57(5):775–788. doi: 10.1016/0002-9343(74)90852-3. [DOI] [PubMed] [Google Scholar]
- Gorevic P. D., Kassab H. J., Levo Y., Kohn R., Meltzer M., Prose P., Franklin E. C. Mixed cryoglobulinemia: clinical aspects and long-term follow-up of 40 patients. Am J Med. 1980 Aug;69(2):287–308. doi: 10.1016/0002-9343(80)90390-3. [DOI] [PubMed] [Google Scholar]
- Kammer G. M., Schur P. H. Binding of circulating immune complexes to human peripheral blood lymphocytes: effect of complement. Clin Immunol Immunopathol. 1978 Jun;10(2):202–213. doi: 10.1016/0090-1229(78)90028-4. [DOI] [PubMed] [Google Scholar]
- Levo Y., Gorevic P. D., Kassab H. J., Zucker-Franklin D., Franklin E. C. Association between hepatitis B virus and essential mixed cryoglobulinemia. N Engl J Med. 1977 Jun 30;296(26):1501–1504. doi: 10.1056/NEJM197706302962605. [DOI] [PubMed] [Google Scholar]
- Lopez L. R., Schocket A. L., Stanford R. E., Claman H. N., Kohler P. F. Gastrointestinal involvement in leukocytoclastic vasculitis and polyarteritis nodosa. J Rheumatol. 1980 Sep-Oct;7(5):677–684. [PubMed] [Google Scholar]
- Mathison D. A., Condemi J. J., Leddy J. P., Callerame M. L., Panner B. J., Vaughan J. H. Purpura, arthralgia, and IgM-IgM cryoglobulinemia with rheumatoid factor acrivity. Response to cyclophosphamide and splenectomy. Ann Intern Med. 1971 Mar;74(3):383–390. doi: 10.7326/0003-4819-74-3-383. [DOI] [PubMed] [Google Scholar]
- Meltzer M., Franklin E. C. Cryoglobulinemia--a study of twenty-nine patients. I. IgG and IgM cryoglobulins and factors affecting cryoprecipitability. Am J Med. 1966 Jun;40(6):828–836. doi: 10.1016/0002-9343(66)90199-9. [DOI] [PubMed] [Google Scholar]