Table 1 Classification and clinico-pathological characteristics of different cryoglobulinemias.
From: Mixed cryoglobulinemia
| Â | Composition | Pathological findings | Clinical associations |
|---|---|---|---|
Type I cryoglobulinemia | monoclonal Ig, mainly IgG, or IgM, or IgA self-aggregation through Fc fragment of Ig | tissue histological alterations of underlying disorder | -lymphoproliferative disorders: MM, WM, CLL, B-cell NHL |
Type II mixed cryoglobulinemia | monoclonal IgM (or IgG, or IgA) with RF activity (often cross-idiotype WA-mRF) and polyclonal Ig (mainly IgG) | -leukocytoclastic vasculitis -B-lymphocyte expansion with tissue infiltrates | -infections (mainly HCV) -autoimmune/lymphoproliferative disorders -rarely 'essential' |
Type II–III mixed cryoglobulinemia | oligoclonal IgM RF or mixture of poly/monoclonal IgM (often cross-idiotype WA-mRF) | -leukocytoclastic vasculitis -B-lymphocyte expansion with tissue infiltrates | -infections (mainly HCV) -autoimmune/lymphoproliferative disorders -rarely 'essential' |
Type III mixed cryoglobulinemia | polyclonal mixed Ig (all isotypes) with RF activity of one polyclonal component (usually IgM) | -leukocytoclastic vasculitis -B-lymphocyte expansion with tissue infiltrates | -infections (mainly HCV) -more often autoimmune disorders -rarely 'essential' |