Morphological changes in peripheral blood of patients with type I and type II cryoglobulinemia

To reveal the clinical diagnostic value of peripheral blood morphological examination by observing the morphological changes of peripheral blood in patients with type I and type II cryoglobulinemia.

This study included 11 patients from Peking Union Medical College Hospital who showed cryoglobulin crystal changes in peripheral blood morphology. Of these, 6 cases were diagnosed by electrophoresis as type I cryoglobulinemia and 5 as type II cryoglobulinemia, and their morphological changes were comprehensively summarized.

Morphological examination of samples containing cryoglobulin crystals revealed the following findings: (1) In type I cryoglobulinemia, erythrocytes were observed encircling the cryoglobulin crystals, whereas in type II cryoglobulinemia, erythrocytes typically did not encircle the crystals unless cryoglobulin levels reached a specific threshold. (2) The morphology of the cryoglobulin crystals varied with time and temperature. (3) Under the microscope, cryoglobulin crystals in type I cryoglobulinemia appeared pale pink, whereas in type II cryoglobulinemia they were light gray and very faint, making them difficult to observe; imaging systems or automated scanners were therefore needed for better visualization.

Compared with normal blood smears, cryoglobulin crystals exhibited significant morphological changes. The use of wet blood smears, low-power lenses, and oil-immersion lenses can reveal diverse morphological features that may vary with time and temperature. Therefore, timely attention to peripheral blood morphological changes plays a crucial role in clinical laboratory testing.