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Case 1. Primary Sjögren’s syndrome-related mixed cryoglobulinemia with peripheral neuropathy, skin lesions, and glomerulonephritis. The chest radiograph (a) and computed tomography scan (b) showed bilateral pleural effusion and alveolar infiltrates. The kidney biopsy showed membranoproliferative glomerulonephritis with abundant infiltrating monocytes and intracapillary "protein thrombi" (c, Masson’s trichrome stain, x400) and “double contours” (d, Jones’ silver stain, x400).
