Recommendations for managing the manifestations of severe and life-threatening mixed cryoglobulinemia syndrome

Publication date: Available online 8 June 2019Source: Autoimmunity ReviewsAuthor(s): Massimo Galli, Giuseppe Monti, Piero Marson, Patrizia Scaini, Maurizio Pietrogrande, Marco Candela, Laura Castelnovo, Paola Faggioli, Paola Novati, Roberta Zani, Maria Teresa Mascia, Francesco Saccardo, Cesare Mazzaro, Piercarlo Sarzi-Puttini, Marco Sebastiani, Luca Quartuccio, Salvatore De VitaAbstractObjectiveSome of the manifestations of mixed cryoglobulinemia syndrome (MCS) can be severe or life-threatening, and should be rapidly contained but, as the therapeutic approaches to such conditions are largely based on anecdotal data, a consensus conference was organised by the Italian Group for the Study of Cryoglobulinemia (GISC) with the aim of providing a set of recommendations based on an in-depth survey of the available data and expert opinion.MethodsThe consensus panel, which included specialists working in different medical fields involved in the management of MCS patients, was first asked to divide the manifestations of MCS into severe or life-threatening conditions on the basis of their own experience, after which a complete literature review was carried out in accordance with the Cochrane guidelines for systematic reviews.ResultsTherapeutic plasma exchange (TPE) was considered the elective first-line treatment in the case of life-threatening manifestations of MCS (LT-MCS) and patients with severe clinical symptoms (S-MCS) who fail to respond to (or who are ineligible for) other treat...
Source: Autoimmunity Reviews - Category: Allergy & Immunology Source Type: research