New insights in cryoglobulinemic vasculitis

Silva, Filipa; Pinto, Claudemira; Barbosa, Arsénio; Borges, Tiago; Dias, Cristina de Oliveira; Almeida, Jorge

doi:10.1016/j.jaut.2019.102313

Cited by 60 publications

(47 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In previous reports, the prevalence of articular involvement was reported to be 40-75%, and the prevalence of nervous system involvement was reported to be 17-60% (mainly peripheral neuropathy) (4,6,7,12). Most studies have shown that the prevalence of cutaneous involvement was approximately 69%−90% (4,7,12,18,19), except for a Spanish single-center study, wherein only 24% of 443 patients had cutaneous involvement (20). It has been reported that purpura, cutaneous necrosis, and articular involvement are associated with early relapse (18), and in one study, significantly low survival rates were observed in patients with renal involvement (12).…”

Section: Discussionmentioning

confidence: 95%

“…In 2011, the classification criteria for cryoglobulinemia vasculitis included general symptoms (such as fever and fatigue), articular involvement, vascular involvement (such as purpura and skin ulcers), and nervous system involvement in the clinical items (16,17). In previous reports, the prevalence of articular involvement was reported to be 40-75%, and the prevalence of nervous system involvement was reported to be 17-60% (mainly peripheral neuropathy) (4,6,7,12). Most studies have shown that the prevalence of cutaneous involvement was approximately 69%−90% (4,7,12,18,19), except for a Spanish single-center study, wherein only 24% of 443 patients had cutaneous involvement (20).…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of gastrointestinal involvement reported in another study was <5%, which was similar to our finding. Moreover, gastrointestinal involvement manifesting as gastrointestinal bleeding or perforation may be related to small vessel vasculitis (2,4). Research on HCV-related systemic vasculitis has shown that patients with gastrointestinal manifestations have higher levels of mixed cryoglobulins (22).…”

Section: Discussionmentioning

confidence: 99%

“…In patients with cryoglobulinemic vasculitis, cryoglobulin immune deposits are always seen in small vessels. Cutaneous, articular, and renal involvement and neuropathy are the most common clinical manifestations (4). There have been many studies on cryoglobulinemia patients.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Renal Involvement and HBV Infection Are Common in Chinese Patients With Cryoglobulinemia

Bai

Zhang

et al. 2021

Front. Immunol.

View full text Add to dashboard Cite

Objectives: This study aimed to describe the main characteristics of Chinese patients with cryoglobulinemia, especially the characteristics of patients with different causes of cryoglobulinemia.Methods: Eighty inpatients diagnosed with cryoglobulinemia from different wards in Peking Union Medical College Hospital were included in this study. Demographic, clinical, biological, and renal pathological data were collected. We analyzed the characteristics of 61 patients with different causes of cryoglobulinemia.Results: Most patients (36/80, 45%) were diagnosed between 40 and 60 years of age. The male: female ratio was 1:1.5. Mixed (II + III) cryoglobulinemia accounted for the majority (43.8%) of cases. Renal involvement (87.5%), cutaneous involvement (57.5%), and fever (27.5%) were the most common clinical manifestations, while other manifestations included serositis and pulmonary and gastrointestinal involvement. The most common renal histopathological pattern was membranoproliferative glomerulonephritis (25/42, 59.5%). The secondary causes of cryoglobulinemia included infectious diseases (26/61, 32.5%), such as hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, and connective tissue diseases (22/61, 27.5%), such as lupus and hematologic tumors (13/61, 16.3%). Patients with hematologic tumors were diagnosed at an older age (P = 0.044) and mostly had type I cryoglobulinemia (P < 0.001). No significant difference in clinical or biological manifestations was found among patients with different causes of cryoglobulinemia.Conclusions: This is the largest cohort of Chinese patients with cryoglobulinemia. We found that renal involvement and HBV infection might be more common in Chinese patients with cryoglobulinemia.

show abstract

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Renal Involvement and HBV Infection Are Common in Chinese Patients With Cryoglobulinemia

Bai

Zhang

et al. 2021

Front. Immunol.

View full text Add to dashboard Cite

show abstract

“…HCV binding to the surface of B cells induces clonal memory B-cell proliferation, reducing the activation threshold and causing widespread autoantibody production, mostly of IgM with RF activity toward anti-HCV IgG. Considering the pathogenesis of MC, different therapeutic strategies have been developed in recent years and are available for patients suffering from this vasculitis [114] , [115] . Therapeutic approaches may be etiologic (the eradication of viral infection conditioning the response of the immune system) and/or pathogenetic (reducing the abnormal response of the immune system of the host).…”

Section: Introductionmentioning

confidence: 99%

Cryoglobulins: Identification, classification, and novel biomarkers of mysterious proteins

Napodano

Gulli²,

Rapaccini

et al. 2021

Advances in Clinical Chemistry

View full text Add to dashboard Cite

Cryoglobulins consist of serum immunoglobulins that precipitate below 37°C and resolubilize upon warming. The clinical triad of cryoglobulinemia usually includes purpura, weakness, and arthralgia. Cryoglobulinemic syndrome, clinically defined as a systemic vasculitis, is associated with chronic infection with hepatitis C virus (HCV) and autoimmune disorders and can evolve into B-cell malignancies. While the current literature about HCV-associated cryoglobulinemia is not very limited, little is known about the immunologic and serologic profiles of affected patients. Therefore, comprehension of the pathogenetic mechanisms underlying cryoprecipitation could be very helpful. Due to the persistence of viral antigenic stimulation, biomarkers to use after the worsening progression of HCV infection to lymphoproliferative and/or autoimmune diseases are widely needed. Laboratory methods used to detect and characterize low concentrations of cryoprecipitates and immunotyping patterns could improve patient management. The most critical factor affecting cryoglobulin testing is that the pre-analytical phase is not fully completed at 37°C.

show abstract

New insights in cryoglobulinemic vasculitis

Cited by 60 publications

References 57 publications

Renal Involvement and HBV Infection Are Common in Chinese Patients With Cryoglobulinemia

Renal Involvement and HBV Infection Are Common in Chinese Patients With Cryoglobulinemia

Cryoglobulins: Identification, classification, and novel biomarkers of mysterious proteins

Cutaneous leukocytoclastic vasculitis associated with verapamil and atorvastatin: A case report

Contact Info

Product

Resources

About