Idiopathic Mixed Cryoglobulinemia: A Diagnostic Challenge

Mixed cryoglobulinemia (MC) is commonly associated with chronic hepatitis C infection. Symptoms usually present as a clinical triad of purpuric rash, arthralgia, and generalized weakness. There have been several case reports establishing the relationship between hepatitis C and MC. Here, we report a case of a 22-year-old female presenting with bilateral lower extremity and facial swelling with no history of hepatitis C developing idiopathic mixed cryoglobulinemia. She was treated with intravenous steroids, rituximab, and plasmapheresis, resulting in improvement with outpatient nephrology and oncology follow-ups.