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cryoglobulinemic vasculitis and glomerulonephritis: concerns in clinical practice

Chinese Medical Journal 2019年第14期132卷 1723-1732页

作者： Yi-Pu Chen Hong Cheng Hong-Liang Rui Hong-Rui Dong Division of Nephrology Beijing Anzhen HospitalCapital Medical UniversityBeijing 100029China

Objective:cryoglobulinemia often causes systemic vasculitis,thereby damaging to skin and internal organs including kidneys,even *** review aimed to introduce the advances in understanding,detection,and treatment of this disease in recent years,with a particular concern to clinical *** sources:All the data in this review were from the English or Chinese literature in the PubMed and China National Knowledge Infrastructure databases as of March *** selection:This review selected important original articles,meaningful reviews,and some reports on cryoglobulinemia published in recent years and in history,as well as the guidelines for treatment of underlying diseases which lead to ***:Diagnosis of cryoglobulinemia relies on serum cryoglobulin test,in which to ensure that the blood sample temperature is not less than 37℃ in the entire pre-analysis phase is the key to avoid false negative *** vasculitis (Cryo Vas),including cryoglobulinemic glomerulonephritis (Cryo GN),usually occurs in types Ⅱ and Ⅲ mixed cryoglobulinemia,and can also be seen in type Ⅰ cryoglobulinemia caused by monoclonal IgG3 or *** purpura,positive serum rheumatoid factor,and decreased serum levels of C4 and C3 are important clues for prompting types Ⅱ and Ⅲ Cryo *** biopsy is an important means for diagnosis of Cryo GN,while membranous proliferative GN is the most common pathological type of Cryo *** recent years,great advances have been made in the treatment of Cryo Vas and its underlying diseases,and this review has briefly introduced these ***:Laboratory examinations of serum cryoglobulins urgently need *** recent advances in the diagnosis and treatment of Cryo Vas and GN need to be popularized among the clinicians in related disciplines.

关键词： cryoglobulin Vasculitis Glomerulonephritis Monoclonal immunoglobulin Hepatitis C virus Autoimmune disease

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Vasculitis with renal involvement in essential mixed cryoglobulinemia:Case report and mini-review

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World Journal of Clinical Cases 2014年第5期2卷 160-166页

作者： Sabiha Anis Khawar Abbas Mohammad Mubarak Ejaz Ahmed Sajid Bhatti Rana Muzaffar Department of Immunology and Molecular Biology Dewan Farooq Medical ComplexSindh Institute of Urology and TransplantationKarachi 74200Pakistan Department of Histopathology Sindh Institute of Urology and TransplantationKarachi 74200Pakistan Department of Nephrology Sindh Institute of Urology and TransplantationKarachi 74200Pakistan

The discovery of a strong association between hepatitis C virus(HCV) infection and mixed cryoglobulinemia(MC) has led to an increasingly rare diagnosis of idiopathic essential MC(EMC).The incidence of EMC is high in regions where there is a comparatively low HCV infection burden and low in areas of high infection prevalence,including *** diagnosis of EMC requires an extensive laboratory investigation to exclude all possible causes of cryoglobulin *** addition,although cryoglobulin testing is simple,improper testing conditions will result in false negative ***,we present a 46-year-old female patient with a case of EMC with dermatological and renal manifestations,highlighting the importance of extensive investigation to reacha proper *** review the need for appropriate laboratory testing,which is often neglected in clinical practice and which can result in false negative *** review also emphasizes the significance of an extended testing repertoire necessary for better patient *** a strong association of MC with HCV infection and other causes that lead to cryoglobulin formation,EMC remains a separate *** diagnosis requires proper temperature regulation during sample handling,as well as characterization and quantification of the *** of rheumatoid factor activity and complement levels in the cryoglobulin test-panel promotes better patient management and *** guidelines should be developed and implemented for cryoglobulin detection and the diagnosis of cryoglobulinemic syndrome,which will reduce variability in inter-laboratory reporting.

关键词： cryoglobulin characterization cryoglobulin detection Essential mixed cryoglobulinemia cryoglobulinemic glomerulonephritis Hepatitis C virus Renal manifestations

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