Essential Mixed Cryoglobulinemia (cont.)

When the cryoglobulin proteins are a mixture of various antibody types, and forming for unknown reasons (essential), the conditions is referred to as essential mixed cryoglobulinemia.

Essential mixed cryoglobulinemia is characterized by joint pains and swelling (arthritis), enlargement of the spleen, skin vasculitis with purplish patches, and nerve and kidney disease. This can lead to recurrent pain in the abdomen, heart attack, and bleeding in the lungs. Weight loss can occur as well as poor appetite.

Essential mixed cryoglobulinemia is sometimes associated with hepatitis C virus infection.

The prognosis and natural history of the illness is not predictable. Kidney damage can be serious and recent reports state that permanent failure of the kidney occurs in approximately 10% of patients. Death can occur, usually from serious heart disease, infection, or brain hemorrhage.

Essential mixed cryoglobulinemia is treated with combinations of medications which reduce inflammation and suppress the immune system. Medications used include nonsteroid antiinflammatory drugs (ibuprofen, aspirin, and others), cortisone preparations (prednisone, prednisolone), cyclophosphamide (Cytoxan), chlorambucil (Leukeran), and azathioprine (Imuran). Plasmapheresis (hemapheresis), a procedure whereby the blood's serum is replaced with saline (salt water), is also performed for severe symptoms.

Recent studies have demonstrated some benefit of using interferon-alpha for those patients with evidence of hepatitis C virus, particularly those with mild disease or in those with remission of manifestations after immune suppression treatment.

Last Editorial Review: 11/7/2007

Source: MedicineNet.com
http://www.medicinenet.com/essential_mixed_cryoglobulinemia/article.htm