Interferon alfa-2b in mixed cryoglobulinaemia: a controlled crossover trial.

Ferri, Clodoveo; Marzo, E; Longombardo, G.; Civita, L. La; Lombardini, Fabrizio; Giuggioli, Dilia; Vanacore, Renato; Liberati, A. M.; Mazzoni, Alessandro; Greco, Francesco

doi:10.1136/gut.34.2_suppl.s144

Cited by 33 publications

(31 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…47,48 Reduction of HCV-RNA is associated with decline of cryocrit, IgM and RF activity. Cryoglobulins may, however, persist even after symptoms resolve.…”

Section: Management Of Cryoglobulinaemiamentioning

confidence: 99%

Cryoglobulin evaluation: best practice?

Sargur

White²,

Egner

2009

Ann Clin Biochem

View full text Add to dashboard Cite

Cryoglobulins are serum immunoglobulins that precipitate at temperatures below 378C and re-dissolve on warming. Cryoglobulinaemia leads to variable symptoms including characteristic purpura, ischaemia of extremities, renal failure, peripheral neuropathy, abdominal pain secondary to intestinal ischaemia and arthralgias. Cryoglobulin testing is underutilized in clinical practice. It has been neglected in clinical laboratories and by clinicians due to several factors, such as the length of time it takes for serum cryoglobulin analysis to be performed in the laboratory, the perceived difficulty in getting optimal sampling conditions and a failure to appreciate that even apparently low levels of cryoglobulin can be associated with severe symptoms in some patients. The most important variable confounding standardization of cryoglobulin testing is improper sample handling. A recent report critically appraising the current practice of cryoglobulin evaluation in 137 laboratories in Europe by United Kingdom National External Quality Assurance Scheme (UKNEQAS) illustrated the wide variability in practice. Although many clinical laboratories perform cryoglobulin evaluation, there are widespread differences in the methodology used and the care with which this is carried out and this leads to considerable intralaboratory and interlaboratory variability. The most common sources of error are false-negative results due to loss of cryoprecipitate during transport and storage. Better standardization is needed to avoid missed diagnoses and improve the comparability of results. Laboratories should ensure that sample temperature is maintained at 378C until the serum is separated. In this article, we briefly review the classification and clinical features of cryoglobulins and suggest best practice guidelines for laboratory detection and identification of cryoglobulins.

show abstract

“…47,48 Reduction of HCV-RNA is associated with decline of cryocrit, IgM and RF activity. Cryoglobulins may, however, persist even after symptoms resolve.…”

Section: Management Of Cryoglobulinaemiamentioning

confidence: 99%

Cryoglobulin evaluation: best practice?

Sargur

White²,

Egner

2009

Ann Clin Biochem

View full text Add to dashboard Cite

show abstract

“…The case reported by Ellis et al [95] can reproduce the early steps of lymphomagenesis intervening in HCV-positive, cryoglobulinaemic and non-cryoglobulinaemic, B-cell neoplasias. Indirect evidence that viral factors can be involved in lymphoproliferation is suggested by the beneficial effect of alphainterferon on the clinico-serological manifestations of HCV AND CANCER 715 mixed cryoglobulinaemia [100], including the regression of lymphomatous infiltrates in the bone marrow [101]. HCV infection could represent one of numerous agents involved in the multistep pathogenesis of such malignancies [4,102].…”

Section: Chronic Hcv Infectionmentioning

confidence: 99%

Viruses and cancers: possible role of hepatitis C virus

Ferri

Civita

Zignego

et al. 1997

Eur J Clin Investigation

View full text Add to dashboard Cite

Abstract. Oncogenesis is a multifactorial process in which environmental, genetic and infectious factors are variably involved. A possible role of specific viruses has been suggested in at least 15% of human cancers. Hepatitis C virus (HCV), which is both hepato-and lymphotropic, is responsible for various liver disorders, i.e. chronic hepatitis, cirrhosis and hepatocellular carcinoma, as well as for a constellation of extrahepatic immune-mediated manifestations, among which is mixed cryoglobulinaemia. This is a systemic disorder secondary to a chronic, benign B-lymphocyte proliferation, which in some subjects may evolve to a malignant non-Hodgkin's lymphoma (NHL). Interestingly, recent studies reported the appearance of malignant B-cell neoplasias in patients with type C chronic hepatitis; moreover, in a significant number (from 22% to 50%) of 'idiopathic' NHLs, the presence of HCV infection has been demonstrated. The presence of a geographical etherogeneity in the prevalence of HCV-positive NHL suggests that other co-factors, i.e. genetic and environmental, could be involved in the lymphomagenesis. HCV may exert its oncogenic potential in two different directions, leading to liver cancer or B-cell lymphoma.

show abstract

“…The central nervous system can sometimes be involved, with transient dysarthria and hemiplegia (52). In patients also affected by HCV hepatitis, liver involvement and neuropathy seem more severe if compared with what is observed in patients without HCV infection (53). Rarely, there may be lung involvement, recurrent abdominal pain and coronary vasculitis (51).…”

Section: Mixed Cryoglobulinaemia (Mc)mentioning

confidence: 99%

Cryoglobulinaemia: A True Internistic Disease?

Manna

Miele

Regina

et al. 2003

Int J Immunopathol Pharmacol

View full text Add to dashboard Cite

Cryoglobulinemia is a clinical condition characterised by the presence of circulating globulins that precipitate at a temperature lower than 37°C and re-dissolve with warming. We can distinguish 3 different types of cryoglobulinemia, according to their immunochemical characteristics. Cryoglobulinemia can be associated with infectious, inflammatory or neoplastic diseases. Cryoglobulinemia type II can be associated with chronic HCV-hepatitis. Clinically, cryoglobulinemias cause hyperviscosity-related symptoms or lesions by immunocomplex deposition (cryoglobulinemic vasculitis). Many organs and systems can be involved, from the skin to the joints, from the central nervous system to the kidney. Diagnosis requires a careful clinical and physical evaluation and the demonstration of circulating cryoglobulins by cryoprecipitation and immunoelectrophoresis. The therapeutic goals are the treatment of the underlying diseases and the complication and prevention of progression/relapse. It is obvious that this disorder can involve different specialists, but the internist plays a central role: heidentifies the disease and the associated condition, he treats the underlying disorder and refers the patient to the specialists for the organ-specific manifestations.

show abstract

Interferon alfa-2b in mixed cryoglobulinaemia: a controlled crossover trial.

Cited by 33 publications

References 7 publications

Cryoglobulin evaluation: best practice?

Cryoglobulin evaluation: best practice?

Viruses and cancers: possible role of hepatitis C virus

Cryoglobulinaemia: A True Internistic Disease?

Contact Info

Product

Resources

About