Cryoglobulinemia: Treatment, Cost and Side Effects

Cryoglobulinemia is a type of disease which is caused by the presence of abnormal proteins or antibodies in the blood called 'cryoglobulins.' This vasculitis occurs mostly at cold temperatures, when these proteins become solid or gel-like and can thus block blood vessels. Blockage of the blood vessels by solid antibodies and thick blood plasma can cause a variety of health problems. Mostly, people face the flares during cold months and rare symptoms occur during the summer months.

Usually the signs and symptoms of this disease is not noted in many people affected by this condition. Symptoms vary from person to person, if present but a few symptoms are noted commonly in patients. These symptoms include breathing problems; fatigue; glomerulonephritis; joint or muscle pain; purpura; Raynaud's phenomenon; skin death; and/or skin ulcers.

In certain cases, the exact underlying cause is not known. But cryoglobulinemia usually occurs in associated with a variety of conditions which include chronic inflammatory diseases (such as autoimmune disease); various kinds of infection; presence of cancer cells in the blood or immune system.

Treatment of cryoglobulinemia will vary depending on the severity of the condition, the symptoms present in each person and the underlying cause. For mild symptoms, patients need to avoid the cold temperature to treat the disease. People with severe conditions may be treated by taking medication. These medicines help to reduce the body's immune response (corticosteroids). It removes some of the blood from the body and replaces it with fluid or donated blood. This process is called plasmapheresis. Another method is to specifically treat the diseases that could be the underlying cause of cryoglobulinemia (such as hepatitis C).

Before the treatment begins, it is important to diagnose the underlying cause of cryoglobulinemia. Diagnostic test of cryoglobulinemia includes a specific blood test that checks for the presence and amount of cryoglobulins in the blood. From the blood test, a doctor will be able to determine if cryoglobulins are present in the blood, its proportion and the type of cryoglobulins present. There are four main types of cryoglobulinemia. These are Type 1, Type 2 and 3, Essential cryoglobulinemia and Secondary cryoglobulinemia. The determination of the type of cryoglobulins present will help a doctor to understand the best method of treatment for the disease. The type may also assist the doctor to identify what underlying condition or disease is causing the cryoglobulinemia.

After diagnosis, the doctor will treat cryoglobulinemia on the basis of the type, the parts of the body affected, the severity of the damage caused, and the underlying disease or condition present. There are several treatment options of cryoglobulinemia. In cases of mild symptoms, there is no need of a conventional treatment. Patients are advised to stay away from the cold weather to prevent further complication. In more moderate to severe cases, a number of treatment options are available. These methods include medicines, filtering blood and infusion of fluid, and other artificial methods. Corticosteroids or other immunosuppressors are prescribed which help stop the immune system from attacking healthy cells. There is another treatment which filters out the clumps of cryoglobulins. Fluids are injected in the body to ease the blood flow and prevent the blockage of arteries and organ damage. This method of treatment is called plasmapheresis. Newer biologic medications, such as rituximab (Rituxan), can prevent the protein forming clumps. These are artificial antibodies that help treat this disease. In cases of secondary cryoglobulinemia, treatment is targeted towards correcting the underlying condition which causes it. When the underlying cause is treated, the symptoms of cryoglobulinemia generally improve as well. If cryoglobulinemia is caused by hepatitis C, the treatment will gear towards an antiviral medication. The patient is usually referred to a liver specialist. Pegylated interferon alfa and a combination of sofosbuvir and ribavirin have been found to be effective in the treatment of cryoglobulinemia and its complications associated with hepatitis C.

Patients who suffer from severe conditions of cryoglobulinemia, with signs and symptoms affecting and hampering the daily activities should opt for the treatment. Also, patients who suffer from secondary cryoglobulinemia are eligible for the treatment as they need to cure the underlying cause first in order to cure cryoglobulinemia.

People with rare symptoms of cryoglobulinemia, such as cough and cold do not require to undergo treatment. They can get better if they start staying away from the cold condition and protect themselves from the cold. No separate treatment is needed for such cases.

Usually, in general, there are no noted side effects of the conventional treatment method. Very rarely, people have shown adverse effects like infection, diarrhoea, nausea etc. But, these side effects are rare and do not show up majorly. However, in case of severe and secondary cryoglobulinemia, treatment may sometimes cause some side effects in people.

Post treatment guidelines mainly involve self care and prevention of the recurrence of the disease. It is important that the patient keeps away from cold as best as possible, continues medicines as prescribed and intakes a lot of healthy food which is helpful in regulating the blood. Any sign and symptom of this disease or similar such must be consulted with the doctor at the earliest.

Time taken for recovery varies from person to person. Some people who suffer only mild symptoms due to the coldness can recover within a week. For others with severe and secondary cryoglobulinemia, recovery takes a little longer time. Depending on the type of treatment provided, patients take around 2-4 week time to recover. Complete recovery for severe cases requires a month or so.

Cryoglobulinemia can be treated in a cost effective way. For those with minor signs and symptoms, keeping away from the cold will cure the problems. They need not undergo any medical treatment. For other instances, medicines and other method may range from Rs 500- Rs. 10000/-.

Yes the treatment results are mostly permanent. But this depends on certain factors like severity of the symptoms, the extent of any damage done, and what underlying causes might be present. If cryoglobulinemia occurs due to any secondary cause, treatment will yield results accordingly. If the disease is left untreated, it can cause permanent damage to organs and the body.

Although there is not sufficient evidence of its effectiveness, some natural methods of treatment can be used to primarily treat the minor signs and symptoms of cryoglobulinemia. For severe cases, alternative medicine can be used as subsidiary alongside the conventional standardized treatment methods, after consulting with the doctors.