Reumatizam, Vol. 62 No. 1, 2015.
Stručni rad
CRYOGLOBULINEMIC VASCULITIS AS A MANIFESTATION OF PARANEOPLASTIC SYNDROME – A CASE REPORT
Jasminka Milas-Ahić
Višnja Prus
Nela Šustić
Roberta Višević
Ivana Kovačević
Željka Kardum1
Sažetak
Cryoglobulinemia refers to the presence of circulating
cryoglobulins in the serum which may lead to organ damage
and systemic response characterized by fatigue, arthralgias,
purpura, glomerulonephritis and neuropathy. Th e disease
mainly aff ects small and medium-sized blood vessels
and causes vasculitis due to cryoglobulin-containing immune
complexes. Mixed cryoglobulinemia (type I and II)
are most oft en associated with infections, especially hepatitis
C virus (HCV), but may occur as part of lymphoproliferative
and autoimmune diseases. We present a 75 -yearold
male patient with acrocyanosis and digital necrosis of
the left hand and purpura of the lower extremities. Since
2001 the patient was treated for Non-Hodgkin’s lymphoma
of the stomach (MALT) and since 2002 for Sjogren’s syndrome.
Extensive diagnostic procedures revealed cryoglobulinemia
type II, but without evidence of HCV infection or relapse of lymphoproliferative disorder. Furthermore,
poorly diff erentiated prostate adenocarcinoma was diagnosed
and antiandrogen treatment was initiated. One
year aft er the onset of symptoms acrocyanosis and digital
necrosis, gastric adenocarcinoma was diagnosed, without
metastatic disease, and surgical treatment was performed.
However, postoperatively recurrence of new digital necrosis
of the hands occurred along with clinical deterioration
and multiple organ failure leading to lethal outcome.
Association of cryoglobulinemia and solid tumors is rarely
described in the literature, so it is very important to
perform comprehensive diagnostic evaluation and detect
potential underlying disease as soon as possible.
Ključne riječi
cryoglobulinemia; paraneoplastic syndrome; prostate cancer; gastric cancer
Hrčak ID:
182714
URI
Datum izdavanja:
9.3.2015.
Posjeta: 7.877 *