It was only a decade ago that the name
"cryoglobulinemia" was proposed by Lerner
and Watson,1 in a case of purpura appearing
upon exposure to cold and associated with
a cold-precipitable globulin in the blood.
Such a protein was accidentally discovered
in 1933 by Wintrobe and Buell2 in a patient with multiple myeloma, who exhibited
purpura, Raynaud's phenomena, and retinal
vein thrombosis. Although very small
traces of cryoglobulins have been demonstrated in a variety of pathological states,
only a limited number of patients with
large amounts of cryoglobulins have thus
far been reported. Essential, or idiopathic,
cryoglobulinemia is a rare condition, only
nine cases having been previously reported.3-11
The association of cold agglutinins with
symptoms of peripheral vascular disorders
has been observed on a number of occasions.12-15 High cold agglutinin titers have
been described most commonly in primary
atypical pneumonia,16 but they also are
found in trypanosomiasis,17 tropical eosinophilia,18 and
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