Primary cryoglobulinemia is more common in young people and middle-aged people, and is slightly more common in women than in men. When the patient’s body surface temperature drops in cold, cold globulin in the blood vessels of the extremities precipitates or becomes jelly-like, blocking the capillaries and causing ischemic necrosis and vasospasm of the blood vessel walls, resulting in purpura and cold urticaria of the skin as the most common.
Cryoglobulin is a kind of protein that precipitates when cold and dissolves when the temperature rises, which can be divided into 3 types. Type I is monoclonal lineage type, that is, monoclonal source of immunoglobulin, there are four kinds of IgG, IgM, IgA and condensation lysin; Type II is mixed type, composed of two or more kinds of immunoglobulin, one of which is monoclonal source; Type III is polyclonal prototype. Type I is not complement resistant and usually causes large vessel injury by an unknown mechanism. Types II and III are both mixed types. Anti-complement, by activating the complement system for immune response and tissue damage, mainly causes small vessel damage. Abnormally increased cryoglobulins can be divided into primary and idiopathic according to their origin. The former is asymptomatic and is only detected during routine examinations, while the latter is often associated with immunoproliferative disorders, infectious disorders, etc.
What are the prevention methods for cryoglobulin precipitation or jelly-like?
1.Treat the original disease, avoid cold, pay attention to keep warm.
2, avoid cold water bath, to prevent the precipitation of cold globulin caused by cold globulin blood syndrome, kidney failure should be actively symptomatic treatment, if necessary, dialysis treatment to alleviate the condition.
3, the usual diet should also pay attention to not eat some cool food, eat more aphrodisiac vegetables and health products.
Various treatment methods are temporary symptomatic treatment. Plasma replacement method: to remove immunoglobulins or immune complexes and rapidly reduce circulating cold globulins to relieve cold-excited symptoms. Corticosteroids have varying degrees of efficacy in controlling fever, skin lesions, and arthralgia. The dose should be equivalent to prednisone 30-50 mg/d. Immunosuppressants: Maintain circulating cold globulin levels without elevating them through toxic effects on dividing cells. Penicillamine: It cleaves disulfide bonds in immunoglobulins, thus depolymerizing IgM and affecting immunoglobulin synthesis, but its clinical efficacy is not yet certain. Interferon: It can be used to treat mixed cryoglobulinemia.