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Since the first description of cryoglobulinemia in association with the clinical triad of 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 (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]
Mixed cryoglobulinemia, gait ataxia, late-onset polyneuropathy syndrome; Myelin-associated glycoprotein-associated gammopathy, polyneuropathy, organomegaly, endocrinopathy, M-protein and skin changes syndrome ; Other possible diagnoses are Bickerstaff brainstem encephalitis; Fisher syndrome; Guillain–Barré syndrome
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