Clinical and Serological Profiles in Cryoglobulinemia : Analysis of Isotypes and Etiologies
Codes-Méndez, Helena (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Jeria-Navarro, Sicylle (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Park, Hye S (Institut de Recerca Sant Pau)
Moya, Patricia (Universitat Autònoma de Barcelona. Departament de Medicina)
Magallares López, Berta Paula (Universitat Autònoma de Barcelona. Departament de Medicina)
Moltó, Elisabeth (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Álvaro, Yolanda (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Mariscal, Anaís (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Moga, Esther (Institut d'Investigació Biomèdica Sant Pau)
Tandaipan, Jose Luis (Institut de Recerca Sant Pau)
Díaz Torne, César (Institut de Recerca Sant Pau)
Laiz, Ana (Universitat Autònoma de Barcelona. Departament de Medicina)
Sainz, Luis (Institut de Recerca Sant Pau)
Castellvi, Ivan (Universitat Autònoma de Barcelona. Departament de Medicina)
Corominas, Hèctor (Universitat Autònoma de Barcelona. Departament de Medicina)

Data:	2024
Resum:	Objectives : Cryoglobulinemia (CG) is marked by abnormal immunoglobulins (Ig) in serum, precipitating at temperatures below 37 °C. Current classification categorizes CG into three subtypes (types I, II, and III) based on Ig clonality. The features distinguishing patients with CG based on their etiology remain unidentified. Aiming to characterize clinical and serological profiles of CG individuals, we conducted an observational analysis of a large cohort of patients and compared their characteristics based on underlying causes: hepatovirus (HV) infections, rheumatic diseases (RD), hematological disorders, and unidentified etiology (essential CG). Methods : We analyzed 252 cryoglobulin-positive serum samples from 182 patients and classified these into the four etiological groups. A separate sub-analysis was carried out for 10 patients meeting criteria for multiple diseases. We collected demographic, clinical, and laboratory data: CG characterization, complement (C3 and C4) levels, antinuclear antibodies (ANA), and rheumatoid factor (RF). Kruskal-Wallis and Wilcoxon-Mann-Whitney U- tests were used for comparisons. Results : Most patients (93. 3%) had mixed cryoglobulinemia (types II + III), with 6. 7% having type I. HV infection, predominantly hepatitis C, was the main (52. 9%) associated condition within the cohort, followed by rheumatic (27. 3%) and hematological (9. 8%) disorders. In our cohort, ANA were frequent (45. 3%) and often associated with RF positivity (43. 6%) and decreased complement levels (C3: 42. 4%, C4: 32. 5%). Essential CG and CG associated with RD had a higher prevalence of cutaneous manifestations (p < 0. 01) and renal involvement (p = 0. 017). Hematological disorder-related CG showed higher cryoglobulin and RF concentrations (p < 0. 01), despite milder symptoms. Conclusions : Our study underscores a mixed prevalence of CG across disease subgroups, with hepatitis-C virus as the primary factor, followed by rheumatic and hematological disorders. Four clinical and serological profiles of CG were identified based on their etiologies.
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Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Cryoglobulinemia ; Vasculitis ; Hepatitis C ; Rheumatic disease ; Hematological disease
Publicat a:	Journal of clinical medicine, Vol. 13, Núm. 20 (October 2024) , ISSN 2077-0383

DOI: 10.3390/jcm13206069
PMID: 39458019

12 p, 279.8 KB

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