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Case report
Positive acute viral infection markers, autoimmune disease and type II mixed cryoglobulinemia: a rare concurrence
  1. Kehua Zhou1,
  2. Shumaila Muhammad Iqbal1,
  3. Ali Alameri1,
  4. Cassandra Zhi2 and
  5. Ammad Naeem1
  1. 1 Catholic Health System Internal Medicine Training Program, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
  2. 2 Drexel University College of Medicine, Philadelphia, PA, USA
  1. Correspondence to Dr Kehua Zhou; kehuazho{at}


Cryoglobulins are abnormal serum immunoglobulins that tend to precipitate in intravascular compartments at temperatures lower than 37°C causing blood flow restriction to vital organs. They are divided into type I, II and III based on the immunoglobulin subtypes of the cryoprecipitates. Type II cryoglobulinemia is most commonly associated with viral infections, autoimmune diseases and lymphoproliferative disorders. Here, we reported an 80-year-old man who presented with fatigue, acute kidney injury, palpable purpura, anaemia and altered mental status. He was diagnosed with type II cryoglobulinemia with concomitant positive autoimmune markers, varicella IgM antibody and IgM hepatitis B core antibody. The patient responded well to intravenous and oral steroid treatment.

  • haematology (incl blood transfusion)
  • immunology
  • rheumatology
  • vasculitis
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  • Contributors SMI, CZ, AN, and KZ participated in the analysis and interpretation of data and wrote the manuscript. SMI and AA were responsible for acquisition of data. AN and KZ revised the manuscript. KZ provided guidance and supervision during manuscript drafting and revision. All authors agreed with the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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