What is Cryoglobulinemia?
The Mayo Clinic states, “Cryoglobulinemia are abnormal proteins in the blood. These protein clump together and cause blood to thicken in lower temperatures.

These gelatinous protein clumps can impede your blood circulation, which can damage your skin, joints, nerves, and organs, particularly your kidneys and liver.”

Cryoglobulinemia is also referred to as a type of vasculitis (enlargement of the blood vessels).

Cryoglobulinemia has been commonly associated with hepatitis C and other conditions and co-infections. Also, blood cancers like lymphoma and multiple myeloma and connective tissue disease such as lupus are associated with cryoglobulinemia.

There are three basic types of cryoglobulinemia based on the clonality and types of immunoglobulins, regarding to the rheumatoid factor binding activity.

  • Type 1: Monoclonal
  • Type 2: Mixed
  • Type 3: Mixed, Polyclonal

Type 2 and 3 have rheumatoid factor activity, which results in joint and muscle pain. Rheumatoid factor is an antibody found in the blood of patients with rheumatoid arthritis.

Hepatitis C is the most common condition associated with mixed cryoglobulinemia (type 2 & 3). It is reported that approximately half of all chronic hepatitis c patients have mixed cryoglobulinemia. Of hepatitis C patients with cryoglobulinemia only 3% experience symptoms.

All patients with cryoglobulinemia should be tested for hepatitis C as well as hepatitis c patients with kidney disorders should be tested for cryoglobulinemia.

Symptoms
The most common symptoms of cryoglobulinemia may include:

  • Purple spots or blotchy areas on the legs.
  • Joint and muscle pain.
  • Numbness and tingly feeling in the fingers and toes.

Other symptoms may include:

  • Raynaud’s Phenomenon (color change in hands or feet from normal to white to purplish/blue color when a person is in cold temperatures.
  • Weight loss
  • High blood pressure
  • Swelling of ankles and legs
  • Skin ulcers and gangrene
  • Enlarged liver or spleen
  • Numbness, tingling or weakness
  • Kidney damage

Testing
A specific blood test can be done to detect the presence of cryoglobulins in the blood. Additional blood tests may be done to see if any organs or functions have been affected.

If you have been diagnosed with hepatitis C, or have symptoms, talk to your physician and ask to be tested for cryoglobulinemia.

Treatment
For hepatitis C patients with cryoglobulinemia, treatment with direct anti-viral therapy for hepatitis c usually prevents recurrence of cryoglobulinemia and the condition may resolve after treatment. If there is no permanent damage to nerves or internal organs, the long-term prognosis is excellent.

There are additional treatments and medication such as corticosteroids, depending on what organs are affected and the degree of damage and other medical conditions. It is best to consider all associated conditions before recommending treatment.

Talk to your physician about being tested for hepatitis C and cryoglobulinemia.

Have you experienced joint and muscle pain or any of the above symptoms?

This entry was originally published in Life Beyond Hep C, and is reprinted with permission.