Surgical problems in idiopathic mixed cryoglobulinaemia

Idiopathic Mixed Cryoglobulinaemia is one of a group of disorders involving serum proteins in which abnormal proteins are found in the serum of affected patients. Such proteins precipitate at low temperatures. In the case of the IMC the cryoglobulins consist both of polyclonal and monoclonal immunoglobulins which then give rise to immunocomplexes. This causes severe damage to the blood circulation in the form of a vasculitic process involving especially the capillaries but also arteries of medium size. It is therefore easy to understand the problems met in these patients when skin grafting and flaps transposition are indicated. The authors continue with the case of a 61 years old female patient, affected by IMC, who presented with an infiltrating ulcerated basalioma of the nose and a large loss of tissue in the right leg and was successfully operated.