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Since the first description of cryoglobulinemia in association with the clinical triad of skin purpura, joint pain, and weakness by Meltzer et al. in 1966, [4] [5] the percentage of cryoglobulinemic diseases described as essential cryoglobulinemia or idiopathic cryoglobulinemia (that is, cryoglobulinemic disease that is unassociated with an underlying disorder) has fallen.
More severe symptoms involve renal, gastrointestinal, and neurological damage with cardiovascular and respiratory complications presenting more rarely in a population of 279 patients with cryoglobulins and hepatitis C infection. [4] Prevalence of these symptoms may vary depending on the underlying etiology contributing to the cryoglobulinemia. [7]
Meltzer's triad describes the classical symptoms suggesting the diagnosis of cryoglobulinaemia of polyclonal CGs seen in essential-, viral-, or connective tissue disease-associated cryoglobulinaemia. [1] The triad consists of: palpable purpura; arthralgia (joint pain) weakness.
Cryofibrinogenemia is also often associated with the inflammatory vasculitis that accompanies mixed Cryoglobulinemia#Classification, i.e. cryoglobulinemic vasculitis, particularly but not exclusively in instances where hepatitis C virus is an underlining disease. [6]
Nonspecific systemic and musculoskeletal symptoms, such as cutaneous vasculitis and neuropathy, can also be seen in patients with mixed cryoglobulinemia. [28] Ninety-five percent of cases of immunoglobulin A vasculitis (IgAV) start with a skin rash. [29]
When present, symptoms vary but may include breathing problems; fatigue; glomerulonephritis; joint pain or muscle pain; purpura; Raynaud's phenomenon; skin death; and/or skin ulcers. In some cases, the exact underlying cause is unknown; however, cryoglobulinemia can be associated with a variety of conditions including certain types of infection ...
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Some intravascular protein deposition diseases causing retiform purpura are cryoglobulinemia (type I), cryofibrinogenemia, and paraproteinemia. Some embolic disorders that may lead to retiform purpura include cholesterol emboli , septic emboli , atrial myxoma , or other manifestations like nonbacterial thrombotic endocarditis (marantic ...