Csepregi A, Nemesánszky E, Bély M
Abt. für Gastroenterologie und Innere Medizin, Landesinstitut fúr Rheumatologie und Physiotherapie, Budapest, Ungarn.
Z Gastroenterol. 1998 May;36(5):391-401.
Cryoglobulinemia can be associated with several infections, immunoproliferative tumors, chronic liver, renal and systemic autoimmune diseases. In the first part of the publication the authors give a review of the main clinical and laboratory properties of cryoglobulins. In essential mixed cryoglobulinemia syndrome (purpura, arthralgia, weakness) clinical and laboratory signs of damaged liver function can often be seen. However, there are mixed cryoglobulins in chronic liver disease of different etiologies as well. In 30-94% of patients with hepatitis C virus infection and hepatitis C virus-induced chronic liver diseases laboratory signs (occasionally clinical symptoms as well) or mixed cryoglobulinemia can be diagnosed. Serological markers of hepatitis C virus infection have been found in the cryoprecipitates of patients with mixed cryoglobulinemia. A high prevalence of mixed cryoglobulins in serum of patients with chronic hepatitis C virus infection and hepatitis C virus-induced chronic liver disease suggests that this virus has a significant role in the pathogenesis of mixed cryoglobulins. Also, an impaired clearance function of the liver in the uptake of cryo(immuno)complexes may be an important causative factor in the production of cryoglobulins in chronic liver diseases of different etiologies.
冷球蛋白血症可与多种感染、免疫增殖性肿瘤、慢性肝脏、肾脏及全身性自身免疫性疾病相关。在该出版物的第一部分,作者对冷球蛋白的主要临床和实验室特性进行了综述。在原发性混合性冷球蛋白血症综合征(紫癜、关节痛、乏力)中,常可见肝功能受损的临床和实验室体征。然而,不同病因的慢性肝病中也存在混合性冷球蛋白。在30%至94%的丙型肝炎病毒感染及丙型肝炎病毒所致慢性肝病患者中,可诊断出实验室体征(偶尔也有临床症状)或混合性冷球蛋白血症。在混合性冷球蛋白血症患者的冷沉淀物中发现了丙型肝炎病毒感染的血清学标志物。慢性丙型肝炎病毒感染及丙型肝炎病毒所致慢性肝病患者血清中混合性冷球蛋白的高患病率表明,该病毒在混合性冷球蛋白的发病机制中起重要作用。此外,肝脏在摄取冷(免疫)复合物时清除功能受损,可能是不同病因慢性肝病中冷球蛋白产生的重要致病因素。