Ruivard M, Tridon A, Quainon F, Rieu V, Fouilhoux A C, Dibet P, Henquell C, Bétail G, Philippe P, Tissot J D
Service de Médecine interne, Hôtel-Dieu, Clermont-Ferrand.
Presse Med. 1996 Oct 26;25(32):1548-9.
Cold agglutinins and cryoglobulins are uncommon in the same patient as observed in our case.
A 74-year-old patient suffered repeated episodes of hemolytic anemia for one year and had hepatitis C anti-virus antibodies. Mixed cryoglobulinemia was found at levels which increased during episodes of acute hemolysis in addition to anti-I cold agglutinins. Two-dimensional electrophoresis revealed identical oligoclonal cold agglutinins and cryoglobulins.
Unlike mixed cryoglobulinemia, cold agglutinins are not known to occur subsequent to hepatitis C infection. The identical immunoglobulins observed in our patient suggest a common origin. Chronic anti-I cold oligoclonal agglutinins are rarely observed and could be an intermediary step towards monoclonal lymphopathy as has been described in prolonged hepatitis C infection.
如我们病例中所观察到的，冷凝集素和冷球蛋白在同一患者中并不常见。
一名74岁患者一年来反复出现溶血性贫血发作，且有丙型肝炎抗病毒抗体。除抗-I冷凝集素外，还发现混合性冷球蛋白血症，其水平在急性溶血发作期间升高。二维电泳显示相同的寡克隆冷凝集素和冷球蛋白。
与混合性冷球蛋白血症不同，冷凝集素在丙型肝炎感染后不会出现。在我们的患者中观察到的相同免疫球蛋白提示有共同起源。慢性抗-I冷寡克隆凝集素很少见，可能是向单克隆淋巴病发展的中间步骤，如在丙型肝炎长期感染中所描述的那样。
