Cryoglobulins are circulating proteins, specifically immunoglobulins (i.e., IgG, IgM, IgA or light chains), that clump together (precipitate) when they are exposed to cold and dissolve when warmed. They may be present in small quantities in the blood of some healthy people but are most frequently associated with abnormal protein production and a variety of diseases and conditions. This test detects and measures the relative quantity of cryoglobulins in the blood.
Precipitated cryoglobulins can slow the flow of blood and block small blood vessels. The presence of large amounts of cryoglobulins in the blood, called cryoglobulinemia, can cause symptoms such as bruising, rashes, joint pain, weakness, and Raynaud phenomenon – pain, paleness, bluing, numbness, tingling and coldness in the fingers and toes with exposure to cold. (These symptoms can also occur in people who do not have cryoglobulinemia.) Cryoglobulins can cause tissue damage that leads to skin ulcers and, in severe cases, to gangrene. They can activate the immune system, leading to the deposit of immune complexes in tissues, and cause inflammation, bleeding, and clotting that can affect circulation in organs such as the kidneys and liver.
Symptoms usually come and go, and may include:
- Skin lesions. Most people with cryoglobulinemia develop purplish skin lesions on their legs. In some people, leg ulcers also occur.
- Joint pain. Symptoms resembling rheumatoid arthritis are common in cryoglobulinemia.
- Peripheral neuropathy. Cryoglobulinemia can damage the nerves at the tips of your fingers and toes, causing numbness and other problems.
Cryoglobulinemia has been associated with:
- Infections. Hepatitis C is the most common infection associated with cryoglobulinemia. Others include hepatitis B, HIV, Epstein-Barr, toxoplasmosis and malaria.
- Certain cancers. Some cancers of the blood, such as multiple myeloma, Waldenstrom macroglobulinemia and chronic lymphocytic leukemia, can sometimes cause cryoglobulinemia.
- Autoimmune disorders. Disease such as lupus, rheumatoid arthritis and Sjogren's syndrome increase the risk of developing cryoglobulinemia.
Depending on the underlying cause of cryoglobulinemia, treatment may include medications that suppress the immune system or fight viral infections. For severe symptoms, your doctor may also recommend a procedure that exchanges your blood plasma, which contains much of the cryoglobulins, for donor plasma or a replacement fluid.
If you have cryoglobulinemia, it's important to avoid exposure to cold — especially to your fingers and toes. You may want to use gloves when using the freezer or refrigerator. Check your feet daily for any injuries, because cryoglobulinemia can make it more difficult for foot injuries to heal.
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