Objective: Cryoglobulinemia often causes systemic vasculitis, thereby damaging to skin and internal organs including kidneys, even life-threatening. This review aimed to introduce the advances in understanding, detection, and treatment of this disease in recent :ears, with a particular concern to clinical practice. Data sources: All the data in this review were from the English or Chinese literature in the PubMed and China National Knowledge Infrastructure databases as of March 2019. Study selection: This review selected important original articles, meaningful reviews, and some reports on cryoglobulinemia published in recent years and in history, as well as the guidelines for treatment of underlying diseases which lead to cryoglobulinemia. Results: Diagnosis of cryoglobulinemia relies on serum cryoglobulin test, in which to ensure that the blood sample temperature is not less than 37 degrees C in the entire pre-analysis phase is the key to avoid false negative results. Cryoglobulinemic vasculitis (Cryo Vas), including cryoglobulinemic glomerulonephritis (Cryo GN), usually occurs in types II and III mixed cryoglobulinemia, and can also be seen in type I cryoglobulinemia caused by monoclonal IgG3 or IgG1. Skin purpura, positive serum rheumatoid factor, and decreased serum levels of C4 and C3 are important clues for prompting types II and III Cryo Vas. Renal biopsy is an important means for diagnosis of Cryo GN, while membranous proliferative GN is the most common pathological type of Cryo GN. In recent years, great advances have been made in the treatment of Cryo Vas and its underlying diseases, and this review has briefly introduced these advances. Conclusions: Laboratory examinations of serum cryoglobulins urgently need standardization. The recent advances in the diagnosis and treatment of Cryo Vas and GN need to be popularized among the clinicians in related disciplines.
基金:
Capital Medical Development Research Fund [2018-2-1051]
第一作者机构:[1]Division of Nephrology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China. [*1]Division of Nephrology, Beijing Anzhen Hospital, Capital Medical University, Anzhen Road No. 2, Chaoyang District, Beijing 100029, China
通讯作者:
通讯机构:[1]Division of Nephrology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China. [*1]Division of Nephrology, Beijing Anzhen Hospital, Capital Medical University, Anzhen Road No. 2, Chaoyang District, Beijing 100029, China
推荐引用方式(GB/T 7714):
Chen Yi-Pu,Cheng Hong,Rui Hong-Liang,et al.Cryoglobulinemic vasculitis and glomerulonephritis: concerns in clinical practice[J].CHINESE MEDICAL JOURNAL.2019,132(14):1723-1732.doi:10.1097/CM9.0000000000000325.
APA:
Chen, Yi-Pu,Cheng, Hong,Rui, Hong-Liang&Dong, Hong-Rui.(2019).Cryoglobulinemic vasculitis and glomerulonephritis: concerns in clinical practice.CHINESE MEDICAL JOURNAL,132,(14)
MLA:
Chen, Yi-Pu,et al."Cryoglobulinemic vasculitis and glomerulonephritis: concerns in clinical practice".CHINESE MEDICAL JOURNAL 132..14(2019):1723-1732