What Triggers Cryo?

One researcher put it this way: “Cryoglobulinemia is the immune systems response to long-standing inflammation….”

• There have been attempts at linking bacterial pneumonia and vaccines for it to connective tissue autoimmune disorders, but it has not been substantiated, and it really looks like it actually triggers an existing autoimmune disorder and not really cause it…. all of the facts are not yet in on this one. (Also, some have tried to link eipsteen-barr virus to cryo, but it is so sketchy that it is not credible.)

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All of this stuff leads one to the idea of “triggers” for the flaring of an autoimmune disorder. This is a particularly hard thing to research and test, so there really are not known and confirmed triggers for a flare, but there are some things that are believed to be potential triggers for a flare.

1. Injury; including surgery.
2. Illness. Some have reported the onset of a flare after encountering a virus, for example.
3. Stress.  Stress can stimulate your immune system and eventually cause it to fail.

The bottom line here is that things that stimulate the immune system may be a bad thing for people with autoimmune disorders.

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Weird/Odd things that once in a while cause cryo; it’s possible but very unlikely for you to get or have most of these.

Here are a few odd things that have not been “officially” associated with cryoglobulinemia, but have caused cryo for a few people in the past.

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• Epstein-Barr Virus and Cryoglobulinemia  Eipstein-Barr virus (infectious mononucleosis) Has long been known to sometimes cause cryoglobulinemia, but the association with cryo remains uncertain. Here is a paper about this topic. The scary part of this is that if it is true, there is a huge number of people at risk for cryo.\http://www.ncbi.nlm.nih.gov/pubmed/2836115  (On a personal note:  I developed infectious mono at the age of 14. I was bedridden for a month and very weak for about 6 months. I sometimes wonder if it is the cause for my cryo. Technically EBV can lead to cryo if the virus is persistent but these things are poorly researched and impossible to prove.)
  

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  Chickengunya virus. A somewhat rare tropical disease. It can be treated , and cured, but will generally spontaneously cure in a year or so and the cryo generally remits.

• Lyme disease, sometime people with Lyme disease develop cryo.
• Malaria A few cases of cryo in malaria patients have been reported.
• Leporacy. Yup! the plague of the ages. It is known to cause cryoglobulinemia. Fortunately, Leporacy can be treated and cured.
• Endocarditis. An infected heart valve can sometimes mimic cryo rather faithfully in terms of symptoms. -cryoglobulins are actually present in these cases… it is pretty rare.
• HIV There have been reports of HIV patients developing cryo. Once they develope full-bown AIDS, the cryo goes away because the immune system is no longer functioning.
• Silicosis. Poisoning with silicate minerals is known to sometimes cause cryo.This is a bad, bad, illness. to have.
• Vinyl Chloride – Exposure. Vinyl chloride poisoning is known to cause cryoglobulinemia. But by that time, the cryo is likely the least of your worries as this is a seriously bad situation to get into.
• parvovirus B19  The certainty of this association with cryo is unknown, but it is often listed as a possible cause for cryo.
• Infectious monoucleosis.  This is caused by both Epstein Barr virus or cytomegalovirus, both have a somewhat uncertain association with cryoglobulinemia that continues to be reported.
• Assorted Herpes viruses: These are among the most common viruses around. Roughly 90-95% of the population has one or more of these viruses. Most people are asymptomatic, some just get sick once and have no further problems, and a few are chronically afflicted.  Herpes viruses which have been named as associated with cryoglobulinemia at one time or another include the following:
  • chicken pox (Herpes varicella), and shingles (Herpes zoster). Chicken pox is a common childhood illness, and can cause outbreaks of shingles later in life when the virus suddenly reactivates.  There is no proven/confirmed association between cryoglobulinemia and chicken pox (herpes vericella) or shingles (herpes zoster) BUT
    • Here is a case report of cold agglutinins and anti-pr-3 antibodies associated with chicken pox!    http://www.ncbi.nlm.nih.gov/pubmed/8249368
    •  another report citing rubella (measles) as well !     http://www.ncbi.nlm.nih.gov/pubmed/9480085
    • yet another author lists herpes vericella as associated with cryoglobulinemia! Note: this is a very old citation that incorrectly lists syphilis as associated with cryoglobulinemia. Scroll down about a half page to see the chart.  https://books.google.com/books… (I sort of have dog in this fight because I was born with chicken pox and am at risk for shingles.)
      

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• Syphilis does NOT cause cryo!
  • But as an interesting side note this venereal disease was once thought that it was associated with cryo because patients with cryo kept testing positive for it.
  • It turned out that a problem with the test was causing a false positive.
  • The test the test for syphilis has since been improved to be a bit more specific. There are still a few doctors around who have not read the news on this one.