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• Vol.63 No.5
• CLINICA NEUROL, 63: 291−297, 2023
• Vol.63 No.5 contents

Case Report

Diagnosis of cryoglobulinemic vasculitis based on B symptoms and peripheral neuropathy:a case report

Monami Tarisawa, M.D.¹⁾, Masahiro Wakita, M.D.¹⁾, Hisashi Uwatoko, M.D., Ph.D.¹⁾, Megumi Abe, M.D.¹⁾, Masaaki Matsushima, M.D., Ph.D.¹⁾ and Ichiro Yabe, M.D., Ph.D.¹⁾

¹⁾ Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University

A man in his 50s presented with a 2-month history of paresthesia and hypoesthesia of the extremities and B symptoms including low-grade fever, weight loss, and night sweats. He also reported a 3-year history of skin discoloration in cold weather. Laboratory test results showed a high white blood cell count and elevated serum Creactive protein and rheumatoid factor (RF) levels. Complement levels were low, and tests for cryoglobulin showed positive results. Computed tomography revealed generalized lymphadenopathy, and ¹⁸F-fluorodeoxyglucose-positron emission tomography showed increased uptake; therefore, we performed cervical lymph node and muscle biopsies. The patient was diagnosed with nodular marginal zone lymphoma and cryoglobulinemic vasculitis (CV) and received chemotherapy and steroid treatment with improvement in symptoms. CV is a rare immune complex small-vessel vasculitis. It is important to measure RF and complement levels and consider infections, collagen diseases, and hematological disorders in the differential diagnosis in patients with suspected vasculitis or CV.
Full Text of this Article in Japanese PDF (5108K)

(CLINICA NEUROL, 63: 291−297, 2023)
key words: cryoglobulin, cryoglobulinemia vasculitis, mononeuritis multiplex, marginal zone lymphoma, B symptoms

(Received: 10-Dec-22)