[2] The incidence of cryoglobulinemic vasculitis is low and highly corresponds to the presence of hepatitis C virus infection, with increased prevalence in Southern Europe.
[5] The large majority of cases of cryoglobulinemic vasculitis are associated with underlying medical conditions which contribute to or exacerbate the pathophysiology, the most common being hepatitis C virus infection.
There are a number of other rheumatologic, oncologic, inflammatory, and infectious associations including Sjogren's syndrome, B-cell lymphoma, rheumatoid arthritis, systemic lupus erythematous, and other hepatitis viral infections.
More severe symptoms involve renal, gastrointestinal, and neurological damage with cardiovascular and respiratory complications presenting more rarely in a population of 279 patients with cryoglobulins and hepatitis C infection.
The first step in quantitative assessment entails identification of the presence of cryoglobulins in the bloodstream, which can be a technically involved and inaccurate process with a high proportion of false-positives and false-negatives.
Baseline laboratory markers, including metabolic panels, urinalysis, and urine protein, should be obtained to trend renal function through progression of the disease and monitor for glomerulonephritis.
[10] Rituximab may also be used in conjunction with glucocorticoids to inhibit B-cell proliferation and therefore decrease cryoglobulin production, although risks include infection and anemia.