Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Cryoglobulinemia is a medical condition that is caused by proteins
called cryoglobulins, which are present in the blood. Cryoglobulins are
abnormal proteins that by
definition have the
unusual property of precipitating from the serum specimen when it is chilled in the
laboratory and redissolving into the serum upon rewarming.
What conditions are associated with
cryoglobulinemia?
Cryoglobulins in the blood (cryoglobulinemia) can cause conditions
throughout the body. These conditions include problems resulting from
abnormal "thickness" of the blood (such as stroke or blood clots in
the eyes leading to blindness) and inflammation of blood vessels,
referred to as vasculitis. Vasculitis of arteries can result in
blockage of arteries leading to damage to the organ(s) supplied by
the affected blood vessels, such as in the skin, kidneys, or
elsewhere.
What is essential mixed cryoglobulinemia?
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.
Kidney failure can occur from an acute event or a chronic condition or disease. Prerenal kidney failure is caused by blood loss, dehydration, medication. Some of the renal causes of kidney failure are from sepsis, medications, rhabdomyolysis, multiple myeloma, and acute glomerulonephritis. Post renal causes of kidney failure include bladder obstruction, prostate problems, tumors, or kidney stones. Treatment options included diet, medications, or dialysis.
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
A stroke results from impaired oxygen delivery to brain cells via the bloodstream. A stroke is also referred to as a CVA, or cerebrovascular incident. Symptoms of stroke include: sudden numbness or weakness of the face, arm or leg. Sudden confusion, trouble speaking or understanding. Sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, or loss of balance, and/or sudden severe headache with no known cause. A TIA, or transient ischemic attack is a short-lived temporary impairment of the brain caused by loss of blood supply. Stroke is a medical emergency.
Hepatitis C is an inflammation of the liver due to the hepatitis C virus (HCV), which is usually spread by
blood transfusion, hemodialysis, and needle sticks, especially with intravenous
drug abuse. Chronic hepatitis C may be treated with interferon, usually in combination with anti-virals.
Arthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of
arthritis including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout,
and pseudogout.
Vasculitis is a general term for a group of uncommon diseases which feature inflammation of the blood vessels. Each form of vasculitis has its own characteristic pattern of symptoms. The diagnosis of vasculitis is definitively established after a biopsy of involved tissue demonstrates the pattern of blood vessel inflammation. Treatment is directed toward decreasing the inflammation of the arteries and improving the function of affected organs.
A skin biopsy is the removal of a piece of skin for the purpose of further
examination in the laboratory using a microscope. Skin biopsies are performed to
diagnose a number of conditions.
Why is a skin biopsy performed?
Skin biopsy is most frequently done to diagnose a skin growth such as a mole,
or a skin condition such as a rash. A skin biopsy can also be used to diagnose a
cancer of the skin. A skin biopsy may be indicated when a mole or other marking
on the skin has changed in its shape, color, or size. A skin biopsy is also
sometimes used to diagnose infections of the skin.
What methods are used to obtain a skin biopsy?
Different techniques are used in different situations. Typically the biopsies
are obtained using local anesthetics.
A shave biopsy takes a thin slice off the
top of the skin and can be used to remove superficial abnorm...
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