Title:Cryofibrinogenemia: What Rheumatologists Should Know
Volume: 18
Issue: 3
Author(s): Mittermayer B. Santiago*Bartira Souza Melo
Affiliation:
- Hospital Santa Izabel, Praça Almeida Couto 500, Salvador, Bahia, Brazil
- Serviços Especializados em Reumatologia da Bahia, Rua Conde Filho, Salvador, Bahia, Brazil
- Serviço de Reumatologia do Hospital Universitário Professor Edgard Santos, Rua Augusto Viana, Salvador, Bahia, Brazil
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil
Keywords:
Cryofibrinogenemia, cryofibrinogen, fibrinogen, cryoprotein, cryoglobulinemia, skin necrosis.
Abstract: Cryofibrinogenemia refers to the presence of cryofibrinogen in plasma. This protein has
the property of precipitating at lower temperatures. Cryofibrinogenemia is a rare disorder, clinically
characterized by skin lesions, such as ulcers, necrosis, livedo reticularis, arthralgia, thrombosis, and
limb ischemia. These features are most often observed in rheumatological practice and consist of
differential diagnoses of antiphospholipid syndrome, primary vasculitis, thrombotic thrombocytopenic
purpura, and cryoglobulinemia. Classical histopathological findings include the presence of
thrombi within the lumen of blood vessels of the skin without vasculitis. To date, there are no validated
classification criteria. Management includes corticosteroids, immunosuppressive therapy, anticoagulants,
and fibrinolytic agents. This narrative review aims to make physicians, particularly
rheumatologists, aware of the existence of this underdiagnosed condition. There are no epidemiological
studies evaluating the prevalence of cryofibrinogenemia in different rheumatological disorders.
Studies are also required to investigate if certain features of rheumatological diseases are related
to the presence of cryofibrinogenemia.