Abstract
Decreased perfusion of the microcirculation underlies the pathophysiology of cryoglobulinemia. Reduced temperature initiates cryoaggregate assembly. Perfusion of the microcirculation is diminished with increasing size of the cryoaggregate. Flow properties of both cryoglobulinemic plasma and solutions of highly purified cryoglobulin derived from a patient with Waldenstrom’s macroglobulinemia are highly dependent on both temperature and shear rate. At low temperature, cryoaggregates can be disrupted by low shear. However, at low temperature and shear rates above 200 sec−1, shear dependent increases in viscosity occurs. Both fibrinogen and D-penicillamine inhibit cryoaggregate formation. The role of cryoaggregation in microcirculation ischemia is presented.
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