The Rheumatologist
COVID-19 News
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Ankylosing Spondylitis Resource Center
    • Gout Resource Center
    • Psoriatic Arthritis Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
    • Interprofessional Perspective
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Systemic Lupus Erythematosus Resource Center
      • Rheumatoid Arthritis Resource Center
      • Gout Resource Center
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / Study Looks at Cryoglobulin Detection & Immunological Characteristics

Study Looks at Cryoglobulin Detection & Immunological Characteristics

November 12, 2020 • By Vanessa Caceres

  • Tweet
  • Email
Print-Friendly Version / Save PDF
Light micrograph of a section through a human artery, showing a large thrombus (blood clot, center) due to cryoglobulinemia.

Light micrograph of a section through a human artery, showing a large thrombus (blood clot, center) due to cryoglobulinemia.
CNRI / Science Source

A study that focused on the detection and immunological characteristics of cryoglobulins provides insights for rheumatologists and other rheumatology providers, as well as lab professionals.

You Might Also Like
  • Cryoglobulins: Quantified & Characterized
  • HCV-Associated Cryoglobulinemic Vasculitis Resolves after Virologic Cure
  • Metabolic Syndrome Linked to Higher Risk for Immunological Disorders
Explore This Issue
November 2020
Also By This Author
  • Staying Connected with Constituents During COVID-19

Co-researchers Marie N. Kolopp-Sarda, PharmD, PhD, and Pierre Miossec, MD, PhD, Clinical Immunology Unit, Department of Immunology and Rheumatology, University of Lyon, France, included in their retrospective study, published in Arthritis & Rheumatology, a large cohort of 13,439 patients who were tested for cryoglobulins—immunoglobulins (Ig) that precipitate in cold temperatures—from January 2010 to December 2016 in Lyon.1

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

Previous studies on the characteristics of cryoglobulins vary due to population selection bias and because of different methods to detect and characterize cryoglobulins, the researchers noted. “The topic is usually seen as complex and even mysterious,” Dr. Miossec says.

The Study

The researchers analyzed cryoglobulin isotype, clonality, concentration and rheumatoid factor in cryoprecipitate, as well as serum complement and rheumatoid factor. They also analyzed markers of gammopathy, viral infection and autoimmunity.

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

If no cryoprecipitates were detected, one or two blood samples were analyzed to confirm the negative result. Cryo­globulins were identified by electro­phoresis-immunofixation of the dissolved cryo­precipitate with various antisera and were then classified by their immuno­globulin clonality profile, according to the classification of cryoglobulin (type I: monoclonal Ig; type II: monoclonal Ig with rheumatoid factor activity; type III: polyclonal Ig with rheumatoid factor activity). Rheumatoid factor activity was measured in the cryoprecipitate and in the serum aliquot. Complement functional activity and C3 and C4 concentration also were measured. Researchers also combined biological data with the most frequent underlying diseases associated with cryoglobulin detection.

Autoantibodies identified as markers of an autoimmune context included double-stranded DNA antibodies, often associ­ated with systemic lupus erythematosus; anti-SSA/Ro60 Ab, often associated with Sjögren’s syndrome; and anti-cyclic citrullinated peptide Ab, associated with rheumatoid arthritis.

Results from the Cryoglobulin Analysis

Cryoglobulins were detected in 1,675 (1,018 women and 657 men; with a mean age of 54 years) of the 13,439 patients. In the full cohort, 89% tested negative for the first sample; 18.5% were retested to confirm the result, and 8.9% then tested positive.

ad goes here:advert-3
ADVERTISEMENT
SCROLL TO CONTINUE

The specialties of origin for the patients were internal medicine (42.9%), neurology (15.1%), hepatology (9.6%), nephrology (9.5%), rheumatology (7.8%), dermatology (5.5%), pulmonary medicine/cardiology (4.2%), hematology (3.7%) and infectious diseases (1.8%).

The study also found that complement activation by immune complexes—specifically, IgM cyroglobulin associated with IgG—is one of the mechanisms contributing to cryoglobulinemic vasculitis, especially hepatitis C-associated cryoglobulinemic vasculitis.

Type I cryoglobulins were present in 9.3% of those who tested positive. About 79% of the type I cryoglobulins were composed of monoclonal IgM, and nearly 21% were monoclonal IgG.

Type II cryoglobulins were found in 788 patients (47%), with 64.9% of the cryoglobulins being monoclonal IgMκ, 19.3% IgMλ, 10.4% IgGκ, 4.4% IgGλ and 1% IgAκ or IgAλ.

Type III cryoglobulins were found in 43.7%. These were most frequently polyclonal IgG and IgM, followed by polyclonal IgG or IgM alone.

Both cryoprecipitate and serum were rheumatoid factor positive in 21.6% of patients with type II cryoglobulins and 10.1% of patients with type III cryoglobulins.

Among the larger patient cohort of more than 13,000 patients, 40% were tested for their autoimmune antibody status. Of those, 11.2% were positive for at least one autoantibody. Among them, 25.4% were positive for cryoglobulin. Type II cryoglobulin was significantly less frequent than type III cryoglobulin in patients with an autoimmune diagnosis. Improvement of techniques used to detect rheumatoid factor in a cryoprecipitate is needed, the researchers note in the study.

The study also found complement activation by immune complexes—specifically, IgM cyroglobulin associated with IgG—is one of the mechanisms contributing to cryoglobulinemic vasculitis, especially hepatitis C-associated cryoglobulinemic vasculitis, the researchers write.

Pages: 1 2 3 | Single Page

Filed Under: Conditions, Research Reviews, Rheumatoid Arthritis Tagged With: cryoglobulinemia, cryoglobulins, Rheumatoid Factor, Sjögren's syndromeIssue: November 2020

You Might Also Like:
  • Cryoglobulins: Quantified & Characterized
  • HCV-Associated Cryoglobulinemic Vasculitis Resolves after Virologic Cure
  • Metabolic Syndrome Linked to Higher Risk for Immunological Disorders
  • New Study Reveals Limitations in ANA Test Kits for Lupus

American College of Rheumatology

Visit the official website for the American College of Rheumatology.

Visit the ACR »

Meeting Abstracts

Browse and search abstracts from the ACR Convergence and ACR/ARP Annual Meetings going back to 2012.

Visit the Abstracts site »

ACR Convergence

Don’t miss rheumatology’s premier scientific meeting for anyone involved in research or the delivery of rheumatologic care or services.

Visit the ACR Convergence site »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2021 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.