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September 1958

Raynaud's Syndrome Associated with Idiopathic Cryoglobulinemia and Cold Agglutinins

AMA Arch Intern Med. 1958;102(3):468-477. doi:10.1001/archinte.1958.00030010468020

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