Essential cryoglobulinemia: a therapeutic dilemma

Our data confirm those already reported in the literature. There is no univocal therapy for essential cryoglobulinemia. Several therapeutic strategies may be employed according to severity of the clinical picture. Skin and articular involvement may benefit from the administration of non-steroidal antiinflammatory drugs. The presence of visceral involvement requires steroids and/or immunosuppressive drugs. Plasma-exchange should be used in patients with severe progressive disease. However, data showing that anyone of the proposed treatment could irreversibly stop the clinical course of the disease are lacking. Immunological parameters except serum viscosity cannot help in the decision to initiate a plasma-exchange program and in monitoring its efficacy.