Atypical presentation of Cryoglobulinemia: Case study

Cryoglobulinemia is the presence of immunoglobulins (Igs) that precipitate at low temperatures in serum. cryoglobulinemia is which classified by the components of the cryoprecipitate into 3 types; type I, isolated monoclonal immunoglobulins; type II, a monoclonal component, usually immunoglobulin M (IgM), possessing activity toward polyclonal immunoglobulins, usually immunoglobulin G (IgG); and type III, polyclonal immunoglobulins of more than one isotype. This classification provided a framework for clinical correlations. The vast number of varied conditions associated with the production of cryoglobulins can be roughly classified into three categories: chronic hepatitis C and other infections, autoimmune diseases, and B-cell lymphoid malignancies. Purpura is the main clinical manifestation of cryoglobulinemia being reported in 55% to 100% of patients. The incidence is higher in patients with type II and III cryoglobulinemia rather in those with type I. In this work a 74-year-old female patient complained from atypical presentation of cryoglobulinemic vasculitis confirmed with histopathology, that led to the discovery of relapsing non-Hodgkin lymphoma in apparently healthy individual.