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Cryoglobulins are immunoglobulins characterized by precipitating when serum is cooled and redissolving when serum is heated. There is strong evidence to consider mixed cryoglobulins as circulating immunocomplexes, and various investigators have applied the precipitating physical property as a method to isolate immunocomplexes. In the recent years some authors have reported the presence of cryoglobulins in acute and chronic liver diseases of diverse etiology. This study investigates the presence of cryoglobulins in 34 patients with different liver diseases. Mixed cryoglobulins were detected in eight patients (23.5 percent), but only three of them had clinical symptoms attributable to the existence of cryoglobulins. In relation to the etiology of the liver disease, the highest frequency has been found among patients with hepatopathies of undetermined origin.

Cryoglobulins are serum immunoglobulins which precipitate in the cold and redissolve on warming at 37 degrees C. According to its immunochemical composition three different types have been described. Cryoglobulins have been reported associated with hematologic disorders, systemic diseases, infectious conditions, and diseases of the liver and kidneys. There is also an idiopathic variant called essential cryoglobulinemia. Five patients (four males) with mixed essential cryoglobulinemia are reported. Common clinical manifestations included fever, articular symptoms, purpura, glomerulonephritis, Raynaud's phenomenon, erythematomacular cutaneous eruption, polyneuritis and abdominal pain. Serum activity of rheumatoid factor has been detected in three cases; in other three decreased levels of serum complement have been found. Serum HBsAg was negative in four cases (passive hemagglutination technique). It is possible that all cases of mixed essential cryoglobulinemia may correspond to bacterial, viral or fungal occult infections.

Cryoglobulins are immunoglobulins characterized by precipitating when serum is cooled and redissolving when serum is heated. There is strong evidence to consider mixed cryoglobulins as circulating immunocomplexes. Cryoglobulins have been demonstrated in association to hematologic, hepatic, lymphoproliferative, autoimmune and infectious conditions. There is also an essential or idiopathic variant. The present report studies a series of 70 patients with several rheumatic and systemic diseases, and a group of ten patients with cutaneous vasculitis. Significant levels of cryoglobulins have been detected in nine cases (overall incidence 12.8 percent). The diagnoses corresponding to these patients were as follows: systemic lupus erythematosus in three cases, dermatopolymyositis in three cases, Sjögren's syndrome in two cases, and Wegener's granulomatosis in one case. Cryoglobulins could not be demonstrated in patients with rheumatoid artritis, sclerodermia, periarteritis nodosa, cutaneous vasculitis, Reiter's syndrome, ankylosing spondilitis and acute articular rheumatism. Among patients with systemic lupus erythematosus a good correlation has been observed between the presence of serum cryoglobulins, the activity and severity of the diseases and the decrease of serum complement levels.

Essential mixed cryoglobulinaemia is a nosological entity described by Meltzer and Franklin in 1966 and characterized by asthenia, arthralgias, purpura, glomerulonephritis and mixed IgM-IgG cryoglobulinaemia. Hepatitis B virus (HBV) markers were studied in the sera and cryoprecipitates of 6 patients with the syndrome. Five (83,3%) had at least one HBV marker and three (50%) had HBsAg either in the serum or in the cryoprecipitate. HBV therefore seems to be involved in the pathogenesis of essential mixed cryoglobulinaemia in a large number of cases.

In order to know the usefulness of beta-2-microglubulin as a tumor marker, the authors measured by radioimmunoassay its serum concentration in 222 patients with solid tumors of different localization. 116 patients with hematologic neoplasms, and 254 cases grouping healthy individuals and patients with diseases other than cancer. The upper limit of normality was considered as 3 micrograms/ml; 35.6 per 100 of the investigated solid tumors and 43.8 per 100 of the blood-forming organs neoplasms gave values higher than 3 micrograms/ml, against only 5 and 10 per 100 of the healthy and non-cancer patients respectively used as a control. Many cancer patients did not show an augmentation of beta-2-microglobulin. The authors consider that beta-2-microglobulin does not offer enough sensitivity and specificity to be used as a tumor marker.