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Purpura, Arthralgia, and IgM-IgG Cryoglobulinemia with Rheumatoid Factor Activity: Response to Cyclophosphamide and Splenectomy

DAVID A. MATHISON, M.D.; JOHN J. CONDEMI, M.D., F.A.C.P.; JOHN P. LEDDY, M.D.; MARY LOU CALLERAME, M.D.; BERNARD J. PANNER, M.D.; and JOHN H. VAUGHAN, M.D., F.A.C.P.
[+] Article and Author Information

Presented in part 19 March 1969, Annual Meeting of The American Academy of Allergy, Miami, Fla.

▸Requests for reprints should be addressed to John J. Condemi, M.D., 260 Crittenden Blvd., Rochester, N.Y. 14620


Rochester, New York


Ann Intern Med. 1971;74(3):383-390. doi:10.7326/0003-4819-74-3-383
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A 50-year-old man was seen for evaluation of urticaria, purpura, and recurrent leg ulcers of 5 years' duration. He was found to have a primary mixed IgM-IgG cryoglobulinemia with rheumatoid factor activity and histologic evidence of cutaneous vasculitis and glomerulonephritis. He received cyclophosphamide for over 18 months with improvement in his clinical course and reduction of the serum cryoglobulin. After splenectomy for hypersplenism the serum cryoglobulin fell precipitously and the clinical course stabilized. The nature and biologic activity of the cryoglobulin, possible pathophysiologic mechanisms operative in the disease, and approaches to therapy are discussed.

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