Cryoglobulinemia often occurs in people with hepatitis C. It is a rare condition that causes inflamed blood vessels that restrict blood flow to vital organs, causing damage to various parts of the body.
Cryoglobulins are abnormal proteins in the bloodstream. In people with cryoglobulinemia, these proteins may clump together in cold temperatures, reducing blood flow and leading to organ, tissue, joint, and nerve damage.
The most common cause of cryoglobulinemia is hepatitis C, although the condition also
In this article, we examine the link between hepatitis C and cryoglobulinemia. We also discuss the symptoms of cryoglobulinemia and explain how doctors diagnose and treat the condition.
Evidence suggests a strong association between hepatitis C and cryoglobulinemia.
Hepatitis C may stimulate the white blood cells, called lymphocytes, to create cryoglobulin. The cryoglobulin then deposits in blood vessels, causing inflammation in tissue and organs.
Although the exact causes are unknown, estimates suggest that about 90% of all cases of cryoglobulinemia occur in people with hepatitis C. The condition is also associated with autoimmune conditions and cancer.
However, the number of people living with hepatitis C who develop cryoglobulinemia, including asymptomatic cryoglobulinemia, is much lower. For example, the National Organization for Rare Disorders states that about 30–50% of people with hepatitis C develop cryoglobulinemia. Of these individuals, about 10–30% develop symptoms.
A 2020 study suggests that doctors should check for both hepatitis C and cryoglobulinemia as part of the diagnostic process due to the relatively high likelihood of a person having both.
Hepatitis C is the most common cause of cryoglobulinemia. However, the exact causes of cryoglobulinemia are unknown.
Researchers suspect that several factors play a role in influencing cryoglobulinemia’s development, including genetic, environmental, and immunological factors.
Cryoglobulinemia can cause various symptoms, including:
- skin rash
- trouble breathing
- bleeding under the skin
- swollen lymph nodes
- kidney damage
- muscle or joint pain
- abdominal pain
However, some people with cryoglobulinemia may not develop any symptoms until they have severe liver damage.
People who also have hepatitis C may experience additional symptoms. The symptoms of hepatitis C include:
A doctor will usually start the diagnostic process by reviewing a person’s medical history and carrying out a physical examination.
Additionally, they may order tests such as:
- blood tests to look for the presence of cryoglobulins
- electromyography (EMG) of the legs and arms
- urinalysis to check for kidney issues
- biopsy of an affected organ or blood vessel
- imaging studies, such as an X-ray, MRI scan, or CT scan
A doctor will also likely test a person for hepatitis C if they do not currently have a diagnosis. Blood tests can determine whether someone has hepatitis C or has previously had exposure to the virus.
The exact areas of the body that cryoglobulinemia affects will determine the treatment approach, which may involve a team of specialists.
Doctors initially treat cryoglobulinemia by targeting the underlying condition causing it, which is often hepatitis C. A doctor may recommend direct-acting antiviral medications or, less often, pegylated interferon with ribavirin to treat the hepatitis C infection. A person may also see an improvement in cryoglobulinemia when receiving treatment for hepatitis C.
If hepatitis C is not the cause, experts recommend that doctors perform a complete evaluation to determine the exact cause of cryoglobulinemia to help guide treatment.
A person may need additional therapies to treat specific areas of concern, depending on how much damage the condition causes. Other treatments may include immunosuppressive medications and nonsteroidal anti-inflammatory drugs (NSAIDs).
A person should talk with a doctor about the various treatment recommendations.
Hepatitis C and cryoglobulinemia often occur together. Hepatitis C is the most common cause associated with cryoglobulinemia, although less than 40% of people living with hepatitis C develop the condition.
Neither cryoglobulinemia nor hepatitis C necessarily causes symptoms, and treating hepatitis C will often help a person recover from both conditions. In people who do not have hepatitis C, doctors can check for other underlying conditions that could cause cryoglobulinemia.