Clinical spectrum, treatment, and outcome of patients with type II mixed cryoglobulinemia without evidence of hepatitis C infection. J Rheumatol ; — Pre-analytical phase in cryoglobulin CRG detection: an alternative method for sample transport. Clin Chem Lab Med ; e—e View Full Text PubMed.
Cryoglobulin test and cryoglobulinemia hepatitis C-virus related. Mediterr J Hematol Infect Dis ; 9:edoi: Cryoglobulin evaluation: best practice? Ann Clin Biochem ; — Motyckova G, Murali M. Laboratory testing for cryoglobulins. Am J Hematol ; — Influence of experimental conditions on the test results of cryoglobulin in Chinese. Chin J Lab Med ; — A critical appraisal of current practice in the detection, analysis, and reporting of cryoglobulins. Clin Chem ; — Kallemuchikkal U, Gorevic PD.
Evaluation of cryoglobulins. Arch Pathol Lab Med ; — Analysis, detection and quantitation of mixed cryoglobulins in HCV infection: brief review and case examples. Clin Chem Lab Med ; — Clinical implications of the types of cryoglobulins determined by two-dimensional polyacrylamide gel electrophoresis. Haematologica ; — Clinical and morphologic spectrum of renal involvement in patients with mixed cryoglobulinemia without evidence of hepatitis C virus infection.
Spectrum and prognosis of noninfectious renal mixed cryoglobulinemic GN. J Am Soc Nephrol ; — The clinical and morphologic spectrum of renal cryoglobulinemia. HCV-negative mixed cryoglobulinemia and kidney involvement: in-depth review on physiopathological and histological bases. Clin Exp Med ; — Rapidly progressive cryoglobulinemic glomerulonephritis. Clin Exp Nephrol ; — Cryoglobu-linemic glomerulonephritis as a presentation of atypical post-infectious glomerulonephritis. J Clin Med Res ; — AJKD atlas of renal pathology: cryoglobulinemic glomerulonephritis. Am J Kidney Dis ; e5—e7.
Serum cryoglobulins and disease activity in systematic lupus erythematosus. J Res Med Sci ; — Glomerular thrombosis in in systemic lupus erythematosus: prevalence and significance. Arthritis Rheum ; — Blood ; — International myeloma working group recommendations for the diagnosis and management of myeloma-related renal impairment.
J Clin Oncol ; — How I treat cryoglobulinemia. Successful treatment with bortezomib in type-1 cryoglobulinemic vasculitis patient after rituximab failure: a case report and literature review. Int J Hematol ; — Efficacy of bortezomib in non-IgM type I cryoglobulinaemic vasculitis : a single-centre retrospective case series. Eur J Haematol ; — Ashley C, Dunleavy A. The Renal Drug Handbook. Type 1 cryoglobulinemia: response to thalidomide and lenalidomide. J Clin Rheumatol ; — Clinical evidence for immunomodulation induced by high-dose melphalan and autologous blood stem cell transplantation as cause for complete clinical remission of multiple myeloma-associated cryoglobulin - vasculitis.
Clinical presentation and outcomes of patients with type 1 monoclonal cryoglobulinemia.
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Clin Oncol R Coll Radiol ; e13—e J Natl Compr Canc Netw ; — Plasma exchange for treating cryoglobulinemia: a descriptive analysis. Transfus Apher Sci ; — Cutaneous ulcers with type I cryoglobulinemia treated with plasmapheresis. Eur J Dermatol ; — Long-term plasmapheresis in conjunction with thalidomide and dexamethasone for the treatment of cutaneous ulcers and neovascular glaucoma in recalcitrant type I cryoglobulinemia. JAMA Dermatol ; — Acute renal failure in essential mixed cryoglobulinemia: precipitation and reversal by plasma exchange.
Clin Nephrol ; — Non HCV-related infectious cryoglobulinemia vasculitis : results from the French nationwide CryoVas survey and systematic review of the literature. J Autoimmun ; — Management of noninfectious mixed cryoglobulinemia vasculitis : data from cases included in the CryoVas survey. Parvovirus Binduced type II mixed cryoglobulinemia. Am J Med ; E7—E8. Cryoglobulinemia vasculitis : how to handle. Curr Opin Rheumatol ; — Treatment of hepatitis C virus infection in patients with mixed cryoglobulinemic syndrome and cryoglobuliemic glomerulonephritis.
Hemodial Int ; 22 Suppl 1 :S81—S J Hepatol ; — Hepatology ; — The World Health Organization.
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Updated version Expert opinion on managing chronic HCV in patients with mixed cryoglobulinaemia vasculitis. Antivir Ther ; 23 Suppl 2 :1—9. Direct-acting antiviral agents in the therapy of hepatitis C virus -related mixed cryoglobulinaemia: a single-centre experience. Arthritis Res Ther ; doi: Effectiveness and cost of hepatitis C virus cryoglobulinaemia vasculitis treatment: from interferon-based to direct-acting antivirals era. Liver Int ; — Long-term efficacy of interferon-free antiviral treatment regimens in patients with hepatitis C virus -associated cryoglobulinemia.
Clin Gastroenterol Hepatol ; — Clin Infect Dis ; — Pre-analysis phase: blood sample collection, tran Analysis phase: qualitative test, quantitative te Cryoglobulinemic vasculitis and glomerulonephritis: concerns in clinical practice. Chinese Medical Journal 14 , July 20, Streptococcal infections are the most common trigger, but respiratory infections are also implicated.
Supportive care is the mainstay of treatment, but occasionally, systemic prednisolone is required. Following resolution, about a quarter of patients will relapse and up to half will have renal abnormalities on follow-up. Urticarial vasculitis is a rare condition that involves the development of indurated wheals, which differ from usual urticaria because they tend to be painful, last longer than 24 hours and resolve with bruising.
The wheals may contain purpuric foci and angioedema may coexist. Evidence of treatment efficacy is limited, but most patients will respond to systemic steroids. Second-line treatments shown to be effective in some cases include dapsone , colchicine and hydroxychloroquine.
Clinical features and diagnosis of small-vessel vasculitis
Microscopic polyangiitis is an ANCA-associated vasculitis predominantly affecting small vessels, although medium vessels can also be involved. It is a necrotising form of vasculitis with very little immune deposition in the vessel walls. There are no granulomas, which helps to differentiate this condition from other ANCA-associated vasculitides.
Glomerulonephritis and pulmonary capillaritis often coexist and constitutional upset is often present. Management involves strong immunosuppression with systemic steroids and cyclophosphamide to induce remission. Granulomatosis with polyangiitis is an ANCA-associated necrotising granulomatous inflammation of small and medium vessels. It commonly involves the upper and lower respiratory tract and causes glomerulonephritis. Dermatological features include palpable purpura, subcutaneous nodules, digital infarcts and ulceration.
Oral ulcers are common and other symptoms include epistaxis, cough, haemoptysis, dyspnoea and nasal deformity. The mainstay of treatment is high-dose prednisolone and cyclophosphamide. Eosinophilic granulomatosis with polyangiitis is an ANCA-associated granulomatous and necrotising vasculitis that is eosinophil rich, involving small to medium vessels. Glomerulonephritis is common and is associated with adult onset asthma. The mainstay of treatment in these patients is high-dose prednisolone and cyclophosphamide. The immune complexes formed cause vasculitis and can affect peripheral nerves, joints and kidneys, as well as the skin.
Acute episodes are triggered by a cold environment and periods of immobility. Management involves a combination of systemic steroids and other immunosuppressive agents. Importantly, if hepatitis C is present, this will need genotyping and treating appropriately. Menna Clatworthy. Core Topics in Vascular Anaesthesia. Carl Moores. ABC of Kidney Disease. David Goldsmith. Breast Pathology E-Book. Frances P. Oxford Case Histories in Rheumatology. Joel David. Tutorials in Endovascular Neurosurgery and Interventional Neuroradiology. James Vincent Byrne.
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