Apheresis in cryoglobulinemia complicating hepatitis C and in other renal diseases

Jesus Dominguez, Edward Sha

Research output: Contribution to journalArticle

24 Citations (Scopus)

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
Pages (from-to)69-76
Number of pages8
JournalTherapeutic Apheresis
Volume6
Issue number1
DOIs
StatePublished - 2002

Fingerprint

Cryoglobulins
Cryoglobulinemia
Blood Component Removal
Hepatitis C
Kidney
Plasma Exchange
Immunoglobulin G
Anti-Glomerular Basement Membrane Disease
Thrombotic Thrombocytopenic Purpura
Focal Segmental Glomerulosclerosis
Lymphoproliferative Disorders
Wounds and Injuries
Virus Diseases
Vasculitis
Antigen-Antibody Complex
Protease Inhibitors
Hepacivirus
Autoantibodies
Immunoglobulin M
Therapeutics

Keywords

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

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Apheresis in cryoglobulinemia complicating hepatitis C and in other renal diseases. / Dominguez, Jesus; Sha, Edward.

In: Therapeutic Apheresis, Vol. 6, No. 1, 2002, p. 69-76.

Research output: Contribution to journalArticle

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