Cryoglobulinemia classification
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Feham Tariq, MD [2]
Overview
Cryoglobulinemia is classically grouped into three types according to the Brouet classification. These are type 1, type 2 and type 3.
Classification
Cryoglobulinemia is classically grouped into three types according to the Brouet classification.[1]
| Types of cryoglobulinemia | |||
|---|---|---|---|
| Associated diseases | Type 1 | Type 2 | Type 3 |
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Type I
- Type I is is a monoclonal immunoglobulin and is most commonly encountered in patients with a plasma cell dyscrasia such as multiple myeloma or Waldenström macroglobulinemia.[2]
- It can lead to a glomerulopathy that is distinct from light chain disease in amyloidosis.
Type II
- Type II is essential mixed cryoglobulinemia and the cryoglobulins are a polyclonal IgG and a momoclonal IgM rheumatoid factor directed against IgG.
- Epstein-Barr Virus (EBV), HIV and Hepatitis B have been implicated but the majority is due to Hepatitis C (HCV).
Type III
- Type III is also a mixed cryoglobulinemia (MC) where both the IgG and IgM are polyclonal.
- It is seen in various autoimmune disorders and lymphoreticular disease as well as hepatitis C in almost 50%.