Meander Medical Center, department of Internal Medicine, Amersfoort, Netherlands.
Meander Medical Center, department of Medical Microbiology and Medical Immunology, Amersfoort, Netherlands.
Ann Hematol. 2024 Oct;103(10):4305-4308. doi: 10.1007/s00277-024-05970-y. Epub 2024 Aug 31.
A 42-year-old male was referred to the internal medicine department because of renal failure and persistent malaise after a recent SARS-CoV-2 infection. Blood results showed anemia and severe renal insufficiency (hemoglobin of 10.3 g/dL and a creatinine of 2.19 mg/dL). Additional tests revealed a type I cryoglobulinemia with a cryoprecipitate composed of dual IgM (kappa and lambda). Further investigations on the cryoprecipitate revealed that the immunoglobulins were directed against SARS-CoV-2 antigens. In the meanwhile, our patient noticed improvement of his symptoms accompanied by resolution of laboratory abnormalities. Three months later, the cryoglobulin could no longer be detected.Type 1 cryoglobulinemia is usually associated with lymphoproliferative disorders and is characterized by various symptoms caused by cryoprecipitates occluding small blood vessels. This is, to our knowledge, the first case of type I cryoglobulinemia with proven precipitation of SARS-CoV-19 antibodies. COVID-19 induced cryoglobulinemia appears to have a mild disease course and to be self-limiting upon viral clearance.
一位 42 岁男性因 SARS-CoV-2 感染后出现肾功能衰竭和持续不适而被转至内科。血液检查结果显示贫血和严重肾功能不全（血红蛋白 10.3g/dL，肌酐 2.19mg/dL）。进一步检查发现 I 型冷球蛋白血症，冷沉淀由双重 IgM（kappa 和 lambda）组成。对冷沉淀的进一步研究表明，免疫球蛋白针对 SARS-CoV-2 抗原。同时，我们的患者注意到症状改善，实验室异常也得到解决。三个月后，已无法检测到冷球蛋白。I 型冷球蛋白血症通常与淋巴增生性疾病有关，其特征是由冷沉淀阻塞小血管引起的各种症状。据我们所知，这是首例有明确 SARS-CoV-19 抗体沉淀的 I 型冷球蛋白血症。COVID-19 诱导的冷球蛋白血症似乎具有较轻的疾病过程，并且在病毒清除后是自限性的。
