Department of Internal Medicine, Nephrology and Health Sciences, University of Parma Medical School, Parma, Italy.
Am J Med. 2010 May;123(5):400-8. doi: 10.1016/j.amjmed.2009.09.038.
Mixed cryoglobulinemia is a chronic immune complex-mediated disease strongly associated with hepatitis C virus (HCV) infection. Mixed cryoglobulinemia is a vasculitis of small and medium-sized arteries and veins, due to the deposition of complexes of antigen, cryoglobulin and complement in the vessel walls. The main clinical features of mixed cryoglobulinemia vasculitis include the triad of palpable purpura, arthralgias, and weakness, and other pathological conditions such as glomerulonephritis, peripheral neuropathy, skin ulcers, and widespread vasculitis. The treatment of HCV-related mixed cryoglobulinemia is difficult due to the multifactorial origin and clinical polymorphism of the syndrome. It can be directed to eradicate the HCV infection, suppress the B-cell clonal expansion and cryoglobulin production, or ameliorate symptoms. The choice of the most appropriate treatment is strictly related to the assessment of disease activity, and to the extent and severity of organ involvement.
混合性冷球蛋白血症是一种慢性免疫复合物介导的疾病，与丙型肝炎病毒（HCV）感染密切相关。混合性冷球蛋白血症是小血管和中等大小血管的血管炎，由于抗原、冷球蛋白和补体复合物在血管壁中的沉积。混合性冷球蛋白血症血管炎的主要临床特征包括可触及性紫癜、关节痛和乏力三联征，以及其他病理情况，如肾小球肾炎、周围神经病、皮肤溃疡和广泛的血管炎。由于该综合征的多因素起源和临床多态性，HCV 相关混合性冷球蛋白血症的治疗较为困难。它可以针对消除 HCV 感染、抑制 B 细胞克隆性扩张和冷球蛋白产生，或改善症状。最适当治疗的选择严格取决于疾病活动度以及器官受累的程度和严重程度的评估。
