Pechère-Bertschi A, Schifferli J A
Département de médecine, Hôpital cantonal universitaire, Genève.
Schweiz Rundsch Med Prax. 1993 Feb 9;82(6):163-7.
The diagnosis of cryoglobulinemia relies on an in vitro artefact, i.e. the precipitation of immunoglobulins induced by a drop in temperature. Cryoglobulinemia has been described in association with neoplasia, infectious and connective tissue diseases. They are classified into two major groups: monoclonal or mixed (more than one type of immunoglobulin). In many patients the mixed type has been described as essential because of the absence of an associated disease. Recent evidence suggests, though, that more than half and probably up to 90% of mixed 'essential' cryoglobulinemias are in fact associated with chronic liver disease due to hepatitis C virus infection. This observation would be in accordance with the clinical response of half of these patients to interferon-alpha therapy; however, more prospective studies are required to confirm the possible beneficial effect of interferon alpha.
冷球蛋白血症的诊断依赖于一种体外假象，即温度下降导致免疫球蛋白沉淀。冷球蛋白血症已被描述与肿瘤、感染性疾病及结缔组织病相关。它们被分为两大组：单克隆型或混合型（不止一种免疫球蛋白类型）。在许多患者中，混合型被称为特发性，因为不存在相关疾病。然而，最近的证据表明，超过半数且可能高达90%的混合型“特发性”冷球蛋白血症实际上与丙型肝炎病毒感染所致的慢性肝病有关。这一观察结果与这些患者中半数对干扰素-α治疗的临床反应相符；然而，需要更多前瞻性研究来证实干扰素-α可能的有益作用。
