Bai Wei, Zhang Lixia, Zhao Jiuliang, Zhang Shangzhu, Zhou Jiaxin, Leng Xiaomei, Liu Zhengyin, Ye Wenling, Han Bing, Tian Xinping, Li Mengtao, Zhao Yan, Zeng Xiaofeng
Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing, China.
Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, National Clinical Research Center on Rheumatology, Ministry of Science and Technology, Beijing, China.
Front Immunol. 2021 Feb 25;12:580271. doi: 10.3389/fimmu.2021.580271. eCollection 2021.
This study aimed to describe the main characteristics of Chinese patients with cryoglobulinemia, especially the characteristics of patients with different causes of cryoglobulinemia. Eighty inpatients diagnosed with cryoglobulinemia from different wards in Peking Union Medical College Hospital were included in this study. Demographic, clinical, biological, and renal pathological data were collected. We analyzed the characteristics of 61 patients with different causes of cryoglobulinemia. Most patients (36/80, 45%) were diagnosed between 40 and 60 years of age. The male: female ratio was 1:1.5. Mixed (II + III) cryoglobulinemia accounted for the majority (43.8%) of cases. Renal involvement (87.5%), cutaneous involvement (57.5%), and fever (27.5%) were the most common clinical manifestations, while other manifestations included serositis and pulmonary and gastrointestinal involvement. The most common renal histopathological pattern was membranoproliferative glomerulonephritis (25/42, 59.5%). The secondary causes of cryoglobulinemia included infectious diseases (26/61, 32.5%), such as hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, and connective tissue diseases (22/61, 27.5%), such as lupus and hematologic tumors (13/61, 16.3%). Patients with hematologic tumors were diagnosed at an older age ( = 0.044) and mostly had type I cryoglobulinemia ( < 0.001). No significant difference in clinical or biological manifestations was found among patients with different causes of cryoglobulinemia. This is the largest cohort of Chinese patients with cryoglobulinemia. We found that renal involvement and HBV infection might be more common in Chinese patients with cryoglobulinemia.
本研究旨在描述中国冷球蛋白血症患者的主要特征，尤其是不同病因所致冷球蛋白血症患者的特征。本研究纳入了北京协和医院不同病房诊断为冷球蛋白血症的80例住院患者。收集了人口统计学、临床、生物学和肾脏病理数据。我们分析了61例不同病因所致冷球蛋白血症患者的特征。大多数患者（36/80，45%）在40至60岁之间被诊断。男女比例为1:1.5。混合性（II + III型）冷球蛋白血症占大多数（43.8%）。肾脏受累（87.5%）、皮肤受累（57.5%）和发热（27.5%）是最常见的临床表现，而其他表现包括浆膜炎以及肺部和胃肠道受累。最常见的肾脏组织病理学类型是膜增生性肾小球肾炎（25/42，59.5%）。冷球蛋白血症的继发原因包括传染病（26/61，32.5%），如乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）感染，以及结缔组织病（22/61，27.5%），如狼疮和血液系统肿瘤（13/61，16.3%）。血液系统肿瘤患者诊断时年龄较大（P = 0.044），且大多为I型冷球蛋白血症（P < 0.001）。不同病因所致冷球蛋白血症患者在临床或生物学表现上未发现显著差异。这是中国最大的冷球蛋白血症患者队列。我们发现肾脏受累和HBV感染在中国冷球蛋白血症患者中可能更为常见。
