Dalai Siba Prasad, Meher Lalit Kumar, Behera Samir Kumar, Nayak Sachidananda, Tripathy Sujit Kumar
Junior Resident, Department of Medicine, MKCG Medical College , Brahmapur, Odisha, India .
Professor, Department of Medicine, MKCG Medical College , Brahmapur, Odisha, India .
J Clin Diagn Res. 2016 Apr;10(4):OD18-9. doi: 10.7860/JCDR/2016/18673.7625. Epub 2016 Apr 1.
Cryoglobulins are monoclonal or polyclonal immunoglobulins that undergo reversible precipitation at low temperatures. Cryoglobulinemia is associated with HCV infection in more than 90% cases, the remaining 10% being called as Essential Cryoglobulinemia which is generally associated with a severe course and suboptimal response to conventional therapies. As the digital vessels are more prone to colder temperatures, hyperviscosity in those vessels can initiate local thrombosis and may manifest as ischemic ulceration and gangrene. We report here a very unusual case of HCV negative cryoglobulinemic vasculitis presenting as symmetrical peripheral gangrene of fingers and toes.
冷球蛋白是单克隆或多克隆免疫球蛋白，在低温下会发生可逆性沉淀。在超过90%的病例中，冷球蛋白血症与丙型肝炎病毒（HCV）感染有关，其余10%被称为原发性冷球蛋白血症，通常与病情严重及对传统疗法反应欠佳有关。由于指（趾）部血管更容易受到低温影响，这些血管内的高黏滞状态可引发局部血栓形成，并可能表现为缺血性溃疡和坏疽。我们在此报告一例非常罕见的HCV阴性冷球蛋白血症性血管炎病例，表现为手指和足趾对称性外周坏疽。
