d. Fever, malaise, epistaxis and haemoptysis.
e. In more than 50% of cases serum IgA is high.Treatment and Prognosis:
Generally, the disease is self-limiting. However 5-20% of cases
(especially adults) may show persistence or even progression to uraemia.
Signs of bad prognosis include patients with: severe disease at
presentation, persistent nephrotic syndrome, severe renal impairment and
crescentic G.N.
Cases with mild disease may be treated symptomatically while
severe cases should be treated with steroids, cytotoxic drugs and plasma
exchange.
Essential Mixed Cryoglobulinaemia
(EMC)
Cryoglobulinaemia is a wide range of diseases associated with
formation of cryoglobulins. The cryoglobulin complex is mainly an
immunoglobulin (antibody) attached to another immunoglobulin (antigen).
The complex has the character of precipitation at cold. According to the
nature of the two immunoglobulins, three types of cryoglobulinaemia are
recognized: 1- monoclonal cryoglobulinaemia (i.e. both components are
monoclonal immunoglobulins), detected in Myeloma,
macroglobulinaemia, chronic lymphatic leukaemia and essential
cryoglobulinaemia. 2- mixed polyclonal-monoclonal cryoglobulinaemia
detected in Sjögren's disease, rheumatoid arthritis and essential mixed
cryoglobulinaemia. 3- mixed polyclonal cryoglobulinaemia (i.e. poly-poly)