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  • Cryoglobulins are cold-precipitable monoclonal or polyclonal immunoglobulins
  • May be associated with vasculitis
    • Palpable purpura, arthralgias, weakness, neuropathy, MPGN, RPGN (rare)
    • Rheumatoid factor (may be a surrogate for cryoglobulin), complement ↓, ESR ↑, anemia
    • Idiopathic
      • Also called "essential mixed cryoglobulinemia"
      • Mostly due to HCV infection
      • 5% of ~HCV-infected p'ts have "essential mixed cryoglobulinemia"
      • MPGN
        • ESRD (15%)
          • 40% later experiencing fatal cardiovascular disease, infection, or liver failure
      • Treatment for HCV (α-interferon)
    • Secondary
      • Multiple myeloma, lymphoproliferative disorders, connective tissue diseases, infection, liver disease