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T. Evans, A. Nicholls, J. Shortland, A. Ward, C. Brown (1984)
Acute renal failure in essential mixed cryoglobulinemia: precipitation and reversal by plasma exchange.Clinical nephrology, 21 5
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Pathogenic paraproteins: gammopathies and cryoglobulinemia.Current opinion in rheumatology, 2 4
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Abstract REPORT OF CASES CASE 1 In November 1989, a 60-year-old white man with a 2-year history of chronic lymphocytic leukemia presented with a 1-week history of pain in both feet accompanied by progressive purpura and petechiae in the lower extremities. Purpura over both lateral malleoli and the right medial tibia ulcerated during the next 2 weeks (Figure 1, top). A skin biopsy specimen of a purpuric lesion revealed vascular occlusion with amorphous, eosinophilic material that was periodic acid Schiff—positive, diastase resistant, and phosphotungistic acid—hematoxylin negative. A mild perivascular infiltrate of lymphocytes and eosinophils was present. Special stains for organisms were negative.The patient's cryoglobulin screen demonstrated a cryocrit of 0.3, 0.2, and 0.5 at temperatures of 4°C, 22°C, and 37°C, respectively. Cryoglobulin analysis revealed a monoclonal IgG-K type I cryoglobulinemia (CG). Despite two courses of chlorambucil (30 mg/d for 5 days every 4 weeks) and prednisone (20 to 60 mg/d), References 1. Boom BW, Brand A, Bouwes-Bavinck J, Eernisse JG, Daha MR, Vermeer B. Severe leukocytoclastic vasculitis of the skin in a patient with essential mixed cryoglobulinemia treated with high-dose γ-globulin intravenously . Arch Dermatol. 1988;124:1550-1553.Crossref 2. Sidi Y, Weinberger A, Berliner S, et al. Relapsing polychondritis associated with mixed cryoglobulinemia . Dermalologica. 1982;165:66-70.Crossref 3. Levo Y. Nature of cryoglobulinemia . Lancet. 1980;1:285-287.Crossref 4. Brouet JC, Clauvel JP, Danon F, Klein M, Seligmann M. Biologic and clinical significance of cryoglobulins: a report of 86 cases . Am J Med. 1974;57:775-788.Crossref 5. Levo Y, Gorevic PD, Kassab HJ, Zucker-Franklin D, Franklin EC. Association between hepatitis B virus and essential mixed cryoglobulinemia . N Engl J Med. 1977;296:1501-1504.Crossref 6. 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Archives of Dermatology – American Medical Association
Published: May 1, 1996
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