cryofibrinogenemia

Etiology

• paraneoplastic syndrome
  • lung carcinoma
  • gastric carcinoma
  • colon carcinoma
  • metastatic prostate carcinoma
  • multiple myeloma
• inflammatory diseases
  • rheumatic fever
  • ulcerative colitis
• thromboembolism
• idiopathic

Epidemiology

• rare

Pathology

• precipitates of fibrinogen, fibrin, fibronectin &/or fibrin degradation products at cooler temperatures
• fibrin thrombi within superficial dermal vessels

Clinical manifestations

• purpura
• livedo reticularis
• painful ulcerations, usually on the legs & unresponsive to treatment

Management

• symptomatic
• treat underlying etiology
• treatment based on limited experience has included:
  • heparin, warfarin, dicumarol, streptokinase, streptodornase, plasmapheresis, dapsone, azathioprine, prednisone, stanozolol
  • stanozole 2 mg PO BID may be effective for cutaneous ulcers

More general terms

• hypercoagulability

Additional terms

• cryoglobulinemia (cryoglobulinemic vasculitis)