Cryoglobulinemic Glomerulonephritis occurs in patients with cryoglobulinemia. The cryoglobulins deposit in the glomeruli causing a glomerulopathy.
Clinical features:
(1) palpable purpura
(2) arthralgias and arthritis
(3) periperal neuropathy
(4) Raynaud’s phenomenon and/or digital skin ulcerations
(5) abdominal pain
These findings may be triggered or made worse by exposure to cold.
Laboratory findings:
(1) hematuria
(2) proteinuria
(3) renal insufficiency
(4) hypocomplementemia
(5) serum cryoglobulins
Cryoglobulinemia
Cryoglobulins
Type 1
single monoclonal protein (often IgG or IgM kappa)
Type 2
single monoclonal protein plus polyclonal immuno-globulin
Type 3
mixed polyclonal immuno-globulns
A kidney biopsy will show the membranoproliferative pattern:
(1) mesangial hypercellularity
(2) nodular mesangial expansion
(3) mesangial interposition
(4) double contouring of the glomerular basement membrane
Immunofluorescence performed on the kidney biopsy will show the various cryoglobulins. A monoclonal cryoglobulin may have a monoclonal light chain. Complement may be present.
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