Can cryoglobulinemia prevent the decrease of CD 4 lymphocytes?
This study reports treatment and disease evolution of a 46-year-old male heroin addict whose dependency dates from 1972. In March 1986, he tested HIV-positive. At that time, he had purpuric lesions and acute thrombopenia (20,000 platelets), associated with cutaneous vasculitis which evolved favourably under veinoglobulin therapy. In June 1987, the patient was rehospitalized with petechial and ecchyomotic purpura of the lower limbs. Leucocyte count was 10,300 (49% polynuclear cells 49% lymphocytes), sedimentation rate 1 mn (first hour), platelets 20,000/mm3, protides 81 g/l, and CD 4 1056/mm3. Type II cryoglobulinemia was discovered associated to the presence of circulating immune complexes, a decrease in C3 and C4 with hyper IgM (4.8 g/l), anti-keratin, actin and smooth muscle anti-bodies, and a very positive rheumatoid factor (808 Ul/l). Clinical evolution was favourable under veinoglobin but purpura of the lower limbs persisted. The patient was started on zidovudine (900 mg per diem)
