Essential Mixed Cryoglobulinemia

  • Medical Author:
    William C. Shiel Jr., MD, FACP, FACR

    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.

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What is the prognosis (outlook) for patients with essential mixed cryoglobulinemia?

The prognosis and natural history of the illness is not predictable. Kidney damage can be serious and some 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.

How is essential mixed cryoglobulinemia treated?

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), steroids (prednisone, prednisolone), cyclophosphamide (Cytoxan), chlorambucil (Leukeran), and azathioprine (Imuran). Plasmapheresis (hemapheresis), a procedure whereby the blood's serum is filtered to remove the cryoglobulins, is also performed for severe symptoms.

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.

Medically reviewed by Jeffrey A Gordon, MD; American Board of Internal Medicine with subspecialties in Oncology and Hematology

REFERENCES:

"Clinical manifestations and diagnosis of the mixed cryoglobulinemia syndrome (essential mixed cryoglobulinemia)"
uptodate.com

Medically Reviewed by a Doctor on 7/7/2015

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