[Cryoglobulinemia in chronic liver diseases: cause or consequence?]

Cryoglobulinemia occurs in a wide spectrum of infectious, autoimmune, neoplastic, renal and liver diseases. In the first part of the publication the authors give a review about laboratory and clinical features of cryoglobulinemia and its associated syndromes. In essential mixed cryoglobulinemia (arthralgia-purpura-weakness) clinical and laboratory evidence of liver involvement are frequently found. In chronic liver diseases of different etiologies mixed cryoglobulins can be detected. In 30-94% of cases of chronic hepatitis C virus infection and chronic liver diseases related to hepatitis C virus laboratory signs (and occasionally clinical symptoms as well) of mixed cryoglobulins have recently been reported. In the cryoprecipitates of these cryoglobulins positive patients markers of hepatitis C virus have been detected. The presence of high prevalence of cryoglobulins in chronic hepatitis C virus infection and chronic liver diseases related to hepatitis C virus suggests a significant role for this hepatotropic virus in the pathogenesis of mixed cryoglobulins. On the other side, the impact of impaired liver function in the clearance of (cryo)immunocomplexes from the serum can be a causative factor in the production of cryoproteins in chronic liver disease of different etiologies.