Cold case: COVID-19-triggered type 1 cryoglobulinemia

Ann Hematol. 2024 Oct;103(10):4305-4308. doi: 10.1007/s00277-024-05970-y. Epub 2024 Aug 31.

Abstract

A 42-year-old male was referred to the internal medicine department because of renal failure and persistent malaise after a recent SARS-CoV-2 infection. Blood results showed anemia and severe renal insufficiency (hemoglobin of 10.3 g/dL and a creatinine of 2.19 mg/dL). Additional tests revealed a type I cryoglobulinemia with a cryoprecipitate composed of dual IgM (kappa and lambda). Further investigations on the cryoprecipitate revealed that the immunoglobulins were directed against SARS-CoV-2 antigens. In the meanwhile, our patient noticed improvement of his symptoms accompanied by resolution of laboratory abnormalities. Three months later, the cryoglobulin could no longer be detected.Type 1 cryoglobulinemia is usually associated with lymphoproliferative disorders and is characterized by various symptoms caused by cryoprecipitates occluding small blood vessels. This is, to our knowledge, the first case of type I cryoglobulinemia with proven precipitation of SARS-CoV-19 antibodies. COVID-19 induced cryoglobulinemia appears to have a mild disease course and to be self-limiting upon viral clearance.

Keywords: COVID-19; Cryoglobulinemia; IgM; Monoclonal; SARS-CoV-2; Viral.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies, Viral / blood
  • COVID-19* / complications
  • Cryoglobulinemia* / etiology
  • Cryoglobulins
  • Humans
  • Immunoglobulin M / blood
  • Male
  • SARS-CoV-2* / immunology

Substances

  • Cryoglobulins
  • Immunoglobulin M
  • Antibodies, Viral