Published:September 09, 2022DOI:



      Cryoglobulinemia is a hematologic condition characterized by the presence of immunologic proteins in the blood, resulting from underlying malignancy to chronic viral processes. The recognition of this condition is critically vital, as patients can first present to the emergency department as their initial manifestation of disease.

      Case Report

      We present a case of cryoglobulinemia, discuss the clinically important types, their presentations, and then emergent complications that can be encountered in the emergency setting. Why Should an Emergency Physician Be Aware of This? Cryoglobulinemia comes in two clinically significant types, both of which can be indicative of an underlying hematologic malignancy, autoimmune, or viral process. The presentation can appear dramatic and can also mimic severe critical illness, for example, meningococcemia. Recognition and appropriate disposition is crucial for the best patient outcome.


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        • Ramos-Casals M
        • Stone JH
        • Cid MC
        • Bosch X.
        The cryoglobulinaemias.
        Lancet. 2012; 379: 348-360
        • Terrier B
        • Karras A
        • Kahn J-E
        • et al.
        The spectrum of type I cryoglobulinemia vasculitis: new insights based on 64 cases.
        Medicine (Baltimore). 2013; 92: 61-68
        • Bonnet F
        • Pineau J-J
        • Taupin J-L
        Prevalence of cryoglobulinemia and serological markers of autoimmunity in human immunodeficiency virus infected individuals: a cross-sectional study of 97 patients.
        J Rheumatol. 2003; 30: 2005-2010
        • García-Carrasco M
        • Ramos-Casals M
        • Cervera R
        • et al.
        Cryoglobulinemia in systemic lupus erythematosus: prevalence and clinical characteristics in a series of 122 patients.
        Semin Arthritis Rheum. 2001; 30: 366-373
        • Ramos-Casals M
        • Cervera R
        • Yagüe J
        • et al.
        Cryoglobulinemia in primary Sjögren's syndrome: prevalence and clinical characteristics in a series of 115 patients.
        Semin Arthritis Rheum. 1998; 28: 200-205
        • Harel S
        • Mohr M
        • Jahn I
        • et al.
        Clinico-biological characteristics and treatment of type I monoclonal cryoglobulinaemia: a study of 64 cases.
        Br J Haematol. 2015; 168: 671-678
        • Muchtar E
        • Magen H
        • Gertz MA.
        How I treat cryoglobulinemia.
        Blood. 2017; 129: 289-298
        • Sidana S
        • Rajkumar SV
        • Disipenzieri A
        • et al.
        Clinical presentation and outcomes of patients with type 1 monoclonal cryoglobulinemia.
        Am J Hematol. 2017; 92: 668-673
        • Meltzer M
        • Franklin EC.
        Cryoglobulinemia—a study of twenty-nine patients. I. IgG and IgM cryoglobulins and factors affecting cryoprecipitability.
        Am J Med. 1966; 40: 828-836
        • Monti G
        • Galli M
        • Invernizzi F
        • et al.
        Cryoglobulinaemias: a multi-centre study of the early clinical and laboratory manifestations of primary and secondary disease. GISC. Italian Group for the Study of Cryoglobulinaemias.
        QJM. 1995; 88: 115-126
        • Musset L
        • Diemert MC
        • Taibi F
        • et al.
        Characterization of cryoglobulins by immunoblotting.
        Clin Chem. 1992; 38: 798-802
        • Cacoub P
        • Comarmond C
        • Domont F
        • Savey L
        • Saadoun D.
        Cryoglobulinemia vasculitis.
        Am J Med. 2015; 128: 950-955
        • Trejo O
        • Ramos-Casals M
        • García-Carrasco
        • et al.
        Cryoglobulinemia: study of etiologic factors and clinical and immunologic features in 443 patients from a single center.
        Medicine (Baltimore). 2001; 80: 252-262