Open AccessPositive acute viral infection markers, autoimmune disease and type II mixed cryoglobulinemia: a rare concurrence
Author(s) -
Kehua Zhou,
Shumaila Muhammad Iqbal,
Ali Al-Ameri,
Cassandra Zhi,
Ammad Naeem
Publication year - 2019
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2019-230492
Subject(s) - medicine , cryoglobulinemia , immunology , lymphoproliferative disorders , cryoglobulin , antibody , autoimmune hepatitis , cryoglobulins , hepatitis , hepatitis c virus , lymphoma , virus
Cryoglobulins are abnormal serum immunoglobulins that tend to precipitate in intravascular compartments at temperatures lower than 37°C causing blood flow restriction to vital organs. They are divided into type I, II and III based on the immunoglobulin subtypes of the cryoprecipitates. Type II cryoglobulinemia is most commonly associated with viral infections, autoimmune diseases and lymphoproliferative disorders. Here, we reported an 80-year-old man who presented with fatigue, acute kidney injury, palpable purpura, anaemia and altered mental status. He was diagnosed with type II cryoglobulinemia with concomitant positive autoimmune markers, varicella IgM antibody and IgM hepatitis B core antibody. The patient responded well to intravenous and oral steroid treatment.