Agrafiotis A, Gluckman J C, Baumelou A, Beaufils H, Jacob N, Legrain M
Clin Nephrol. 1981 Sep;16(3):146-50.
Sera from 105 adult patients with idiopathic chronic glomerulonephritis (GN) were investigated to assess the diagnostic and prognostic value of cryoglobulin (CG) detection. CG+ sera were found in 49% of cases but also in 34% of normal donors. CG composition in these two groups was different. Concentrations of CG greater than micron g/ml were considered as abnormal, since concentrations did not exceed this value in the controls. Using this criterion 30% of patients with GN had CG; most had membrano-proliferative GN, GN with mesangial IgA deposits, and membranous GN. CG occurred with the same frequency but at higher concentrations in the group of patients with diffuse proliferative GN than in other groups; however, there was no difference in the frequency and concentration of CG when GN was thought to be mediated by immune complexes (IC) than when it was not. No relationship was observed with disease activity. In conclusion low CG might represent an in vitro artifact of a common in vivo immunoregulatory mechanism in normal donors. Although they might be a marker for the presence of IC in adult patients with GN not related to systemic disease, CG detection appears to be of little help in diagnosis, assessment of disease activity, or therapeutic monitoring.
对105例特发性慢性肾小球肾炎（GN）成年患者的血清进行了研究，以评估冷球蛋白（CG）检测的诊断和预后价值。在49%的病例中发现了CG阳性血清，但在34%的正常供体中也有发现。这两组的CG组成不同。CG浓度大于微克/毫升被认为异常，因为对照组中浓度未超过此值。采用该标准，30%的GN患者有CG；大多数为膜增生性GN、系膜IgA沉积性GN和膜性GN。弥漫性增生性GN患者组中CG出现的频率相同，但浓度高于其他组；然而，当认为GN由免疫复合物（IC）介导时与不由免疫复合物介导时，CG的频率和浓度没有差异。未观察到与疾病活动的关系。总之，低CG可能代表正常供体中常见的体内免疫调节机制的体外假象。尽管CG可能是与系统性疾病无关的成年GN患者中IC存在的标志物，但CG检测在诊断、疾病活动评估或治疗监测方面似乎帮助不大。
