Baby, it's cold outside!

Guidelines on the diagnosis and management of Waldenström macroglobulinaemia

“…Underlying HCV infection is demonstrable in some patients. Type II cryoglobulinaemia is clinically characterized by purpura, cutaneous ulceration, peripheral neuropathy, arthralgia and glomerulonephritis (Bryce et al , ; Gertz, ; Terrier et al , ). There are limited published data on the treatment of patients with cryoglobulinaemia.…”

“…Cryoglobulins, immunoglobulins that precipitate on cooling, are demonstrable in approximately 1% of individuals with monoclonal proteins (Bryce et al, 2006 (Bryce et al, 2006;Gertz, 2012;Terrier et al, 2012).…”

Waldenström macroglobulinaemia: the key questions

“…Waldenström macroglobulinaemia (WM) is defined by the World Health Organization as a lymphoplasmacytic lymphoma (LPL) associated with a monoclonal immunoglobulin M (IgM) protein of any size (Owen et al , ; Swerdlow et al , ). The classic pentad of WM is (i) monoclonal protein on serum protein electrophoresis, (ii) the monoclonal protein confirmed to be IgM by immunofixation, (iii) bone marrow evidence of LPL, (iv) evidence of hyperviscosity syndrome in some patients and (v) normocytic anaemia in some patients (Gertz, ). According to data from the Surveillance, Epidemiology, and End Results program, WM represents 1·9% of all non‐Hodgkin lymphomas (Wang et al , ).…”

“…Type II cryoglobulinaemia is composed of monoclonal and polyclonal immunoglobulins. Whereas type I cryoglobulinaemia tends to be an incidental finding without symptoms or signs (Gertz, ), patients with type II or mixed IgM‐IgG cryoglobulinaemia can have various symptoms and signs related to cold sensitivity, purpura, arthralgias, and vasculitis (Stone, ). Additionally, type II cryoglobulinaemia has a marked effect on serum viscosity owing to the high thermal amplitude of the IgM‐IgG cryoglobulin (Stone, ).…”