Cryoglobulinemia is a big word. My spell checker refuses to recognize it no matter how many times I add it to the dictionary. Such is life. I don’t know how many are afflicted with this disease but it seems to travel with HCV as frequently as PCT does.
Cryo, if you will permit me to abbreviate or shorten it, is a disease where the body seems to accumulate large amounts of Gamma globulin proteins that coagulate in the blood at lower temperatures. If you have ever suffered from this, the immediate effect is aching hands and feet in cold weather. The repair order is to get warm in a hurry. This causes even more pain until the protein doomoflotchies liquify like the butter you pour on your popcorn.
As you can see, there are three distinct flavors of this from the Wikkie link. HCV sufferers seem to get the one with the high IgG version. This link calls it Type II or III, but I have seen them numbered differently depending on where the article was written (i.e. England, Israel, etc.). While everyone has slightly different symptoms, the one I mentioned is the hallmark. Others sometimes complain of symptoms as far ranging as achy joints which is usually an indicator of Rheumatoid Arthritis or Fibromyalgia. When this is a factor, you will usually see a component of autoimmune disorder evidenced by a high Anti-nuclear antibody (ANA) test and an elevated RA factor in the blood.
More than one member has asked me if I experience some (or all) of these symptoms. Yes and no. When I tried out for the Interferon audition in 2007, all hell broke loose. This was due in no small part to my underlying autoimmune disfunction. I didn’t have the panoply of diseases then that later showed up. Interferon is like throwing 100 gallons 130 octane Avgas on a well-developed house fire. It takes it up several notches. If you suffer from any of the run of the mill autoimmune disorders such as Sjogren’s, Crohn’s, RA, UC or the like, Interferon will be your worst enemy. Chances are if you don’t have Cryo yet, you will after starting treatment. Some can tolerate the harsh effects of the IFN treatment for a while, but ultimately it will ramp up the immune system to attack everything in your body, including your liver. This is called autoimmune hepatitis and will accelerate the HCV disease process exponentially. You will see viral load counts higher than any of your previous best. I jumped from 27,000 to 8.5 million in less than seven months and it took several years to get it back down. All that from just one dose of the rat piss. ANA tests are measured like the doubling cube in a backgammon game-i.e. 2,4,8,16,32,64, 128 etc. They start at 1:40 and proceed up the same exponential ladder. Hence the next is 1:80 followed by 1:160 and so on. I hit 1:2510 and I was one sick doggie. There is probably no way to describe how you feel so I won’t try.
The testing process for Cryo is very unique. You have to go to a hospital with a laboratory for this. They heat up a test tube to keep your blood warm and keep the vial in a bath of heated water while they prepare the sample for testing. My tests revealed a reading of 3910 micrograms per whatever which is way up there. I suspect normal is more like 40. You’ll know if its elevated if you go outside when its less than 50 degrees. Your hands generally turn white because no blood can enter the extremities. When you reenter a warm, heated area the agony is indescribable. The pain subsides gradually as the cryoglobins dissolve or liquify.
While I can’t swear to it medically, the high IgG rate seems to provoke cognitive issues. It may be a brain fart or simply old age, but it seems worse when the levels are running high. The good news is phlebotomies. They tend to reduce this to a manageable level where the symptoms are not so pronounced. Talking your doctor into a regular phlebotomy regimen is going to be a challenge. There is actually nothing deleterious about it, but you have to remember that doctors in the 17th, 18th and even the 19th centuries regularly engaged in the practice of bloodletting and using leeches. We’ve come a long way- perhaps too far. Doctors are so staid in their ways , they look at this as quackery from the dark ages and refuse to entertain it. Nevertheless, there seems to be some correlation between the two.
Absent a really good automobile accident with a resultant high loss of blood requiring a transfusion, you will never get to experience a reduction in IgG. Discussing this with doctors is recommended , but arm yourselves with the facts before you go in. Most gastrodocs are not well-versed in hepatology unless they opt to specialize in it. Don’t get me wrong. They go through the normal classes in med school touching on the ill effects of hepatitis on the liver, but mostly with the more common HAV and HBV scenarios. HCV is usually referred to specialists in that specific area of expertise.
Hepatologists are a unique breed. They all have that cattle drive mentality towards the different treatment protocols involving the menu of IFN and Ribavirin. With the addition of Telepravir and Bocepravir to the appetizer list, they simply have more options. They rarely think outside the box and look at other procedures that may have a beneficial effect on your well-being. This phlebotomy thing would never have arisen absent my PCT. The resultant beneficial effects from it also would never have surfaced unless I had a baseline of horrible health to measure it against. The difference in how I feel is definitely a night and day proposition.
If you have HCV and haven’t been tested for the IgA, IgG and IgM group of globulins, you might politely ask your doctor where he got his diploma. I would point out that you do not necessarily have to have an autoimmune disorder to have this nor have gone through Ifn therapy. Some only need the risk of HCV to provoke this animal.