Apheresis in cryoglobulinemia complicating hepatitis C and in other renal diseases

Jesus H. Dominguez, Edward Sha

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

Removal of cryoglobulins by plasma exchange is now an accepted therapy. Cryoglobulins are circulating complexes that can deposit on small vessels and cause limited or extensive tissue injury. There are 3 major classes of cryoglobulins. Type I cryoglobulins are monoclonal and are detected in a variety of lymphoproliferative disorders. Type II cryoglobulins are mixed containing monoclonal and polyclonal IgG or IgM molecules. Type III cryoglobulins are also mixed and contain polyclonal IgG. Type II cryoglobulins are largely caused by hepatitis C virus infection; hence, they are the most common of the 3 types. In hepatitis C, cryoglobulins are linked to glomerular immune complex injury, oftentimes accompanied by vasculitis of the skin, nerves, and other vital organs. Immediate removal of cryoglobulins by plasma exchange is an effective short-term treatment that can complement more-specific therapies. Plasma exchange has also been used to remove other circulating nephrotoxic agents such as antiglomerular basement antibodies that cause Goodpasture's syndrome, protease inhibitor autoantibodies that cause thrombotic thrombocytopenic purpura, and antiglomerular factors that cause some types of focal glomerulosclerosis.

Original languageEnglish (US)
Pages (from-to)69-76
Number of pages8
JournalTherapeutic Apheresis
Volume6
Issue number1
DOIs
StatePublished - Mar 23 2002

Keywords

  • Apheresis
  • Cryoglobulinemia
  • Hepatitis C
  • Immune complex glomerulonephritis
  • Plasma exchange
  • Renal disease

ASJC Scopus subject areas

  • Medicine(all)

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