| Abstract | Uvod: Krioglobulini su proteini koji precipitiraju pri temperaturi ispod 37°C, a njihova prisutnost u serumu zove se krioglobulinemija. Tip 1 krioglobulinemije veže se uz limfoproliferativne bolesti, dok se tipovi krioglobulinemije 2 i 3 povezuju s infekcijom virusom hepatitisa C, neoplazmama te sustavnim autoimunim bolestima.
Ciljevi: Cilj ovog istraživanja je usporediti laboratorijske i kliničke značajke između bolesnika s krioglobulinemijom tipa 2 i tipa 3.
Ispitanici i metode: Riječ je o presječnoj studiji temeljenoj na podacima iz bolničke arhive. Uključeni su bolesnici kojima je u razdoblju od tri godine dokazana prisutnost krioglobulina u serumu. Analizirana su klinička i laboratorijska obilježja koja su zatim uspoređena između bolesnika s krioglobulinemijom tipa 2 i 3.
Rezultati: Prisutnost krioglobulina dokazana je kod ukupno 38 bolesnika (krioglobulinemija tip 2 – 10 bolesnica; krioglobulinemija tip 3 – 24 bolesnice i 4 bolesnika). Kod bolesnika s krioglobulinemijom tipa 2 pronađena je značajno viša vrijednost reumatoidnog faktora (359,9, IKR 106,6-379,5 IU/ml vs. 20, IKR 13,4-93,4 IU/ml, p=0,007) i krioprecipitata (385,5, IKR 216,5-492,5 mg/L vs. 119,5, IKR 82,3-156 mg/L, p<0,001) te niža vrijednost C4 (0,04, IKR 0,03-0,08 g/L vs. 0,13, IKR 0,06-0,19 g/L, p=0,025) i gama globulina (9,3, IKR 8,1-12,2 g/L vs. 12,5, IKR 9,6-19 g/L, p=0,029) u usporedbi sa bolesnicima s krioglobulinemijom tipa 3. Dijagnoza SLE-a postavljena je kod 21 bolesnika (tip 2 - 8 bolesnika vs. tip 3 - 13 bolesnika, p=0,137). Dijagnoza Sjögrenovog sindroma utvrđena je kod 8 bolesnika (tip 2 - 6 bolesnika vs. tip 3 - 2 bolesnika, p=0,002).
Zaključak: U analiziranoj skupini bolesnika najčešće su prisutne dijagnoze Sjögrenovog sindroma i SLE-a. Dijagnoza krioglobulinemije tipa 2 rjeđa je od krioglobulinemije tipa 3, a povezana je sa Sjögrenovim sindromom i izraženijim utroškom komplementa. |
| Abstract (english) | Introduction: Cryoglobulins are proteins that precipitate at the temperature below 37°C, and their presence in the serum is called cryoglobulinemia. Cryoglobulinemia type 1 is associated with lympfoproliferative disorders, while cryoglobulinemia types 2 and 3 are associated with hepatitis C infection, neoplasms and systemic autoimmune diseases.
Aim: The aim of this study was to compare laboratory and clinical features between patients with cryoglobulinemia type 2 and 3.
Patients and methods: For this cross-sectional study data were obtained from the hospital archives. Patients positive for cryoglobulinemia in their serum over a period of three years were included in the study. Clinical and laboratory characteristics were analyzed and then compared between patients with cryoglobulinemia type 2 and 3.
Results: The presence of cryoglobulin was proven in a total of 38 patients (cryoglobulinemia type 2 – 10 female patients; cryoglobulinemia type 3 – 24 female patients and 4 male patients). In patients with cryoglobulinemia type 2, we identified a significantly higher value of rheumatoid factor (359.9, IQR 106.6-379.5 IU/ml vs. 20, IQR 13.4-93.4 IU/ml, p=0.007) and cryoprecipitate (385.5, IQR 216.5-492.5 mg/L vs. 119.5, IQR 82,3-156 mg/L, p<0.001), and a lower value of C4 (0.04, IQR 0.03-0.08 g/L vs. 0.13, IQR 0,06-0,19 g/L, p=0.025) and gamma globulin (9.3 , IQR 8.1-12.2 g/L vs. 12.5, IQR 9.6-19 g/L, p=0.029) compared to patients with cryoglobulinemia type 3. The diagnosis of SLE was made in 21 patients (type 2 - 8 patients vs. type 3 - 13 patients, p=0.137). the diagnosis of Sjögren's syndrome was established in 8 patients (type 2 - 6 patients vs. type 3 - 2 patients, p=0.002)
Conclusion: In the analyzed group of patients, the most common diagnoses were Sjögren's syndrome and SLE. The diagnosis of cryoglobulinemia type 2 was less common than cryoglobulinemia type 3, and it was associated with Sjögren's syndrome and a more pronounced hypocomplementemia. |
