Raynaud's Syndrome Associated with Idiopathic Cryoglobulinemia and Cold Agglutinins

It was only a decade ago that the name was proposed by Lerner and Watson, 1 in a case of purpura appearing upon exposure to cold and associated with a cold-precipitable globulin in the blood. Such a protein was accidentally discovered in 1933 by Wintrobe and Buell 2 in a patient with multiple myeloma, who exhibited purpura, Raynaud's phenomena, and retinal vein thrombosis. Although very small traces of cryoglobulins have been demonstrated in a variety of pathological states, only a limited number of patients with large amounts of cryoglobulins have thus far been reported. Essential, or idiopathic, cryoglobulinemia is a rare condition, only nine cases having been previously reported. 3-11 The association of cold agglutinins with symptoms of peripheral vascular disorders has been observed on a number of occasions. 12-15 High cold agglutinin titers have been described most commonly in primary atypical pneumonia, 16 but they also are found in trypanosomiasis, 17 tropical eosinophilia, 18 and