[Mixed cryoglobulinemia]

Cryoglobulins are immunoglobulins that persist in serum, precipitate with cold temperature, and resolve when rewarmed. Cryoglobulinemia are part of systemic vasculitis, and they are in the subgroup of immune complex type vasculitis. Mixed cryoglobulinemia are associated with malignant B lymphoproliferative disorders, auto-immune and chronic infectious diseases, particularly hepatitis C virus infection. Mixed cryoglobulinaemia has a variable prognosis, depending mainly on renal involvement, systemic extension, and severity of hypertension. In pilot studies, alpha interferon seemed promising to treat symptomatic mixed cryoglobulinemia, because of its immunomodulating and antiviral properties. In severe or resistant forms of mixed cryoglobulinemia, plasmapheresis or immunosuppressive agents may be useful.