Table 1. Proposed criteria for the... | American Society of Hematology

Table 1.

Proposed criteria for the diagnosis and classification of patients with mixed cryoglobulinemia.⁴

Criteria	Serologic	Pathologic	Clinical
Abbreviations: HCV, hepatitis C virus; HBV, hepatitis B virus; HCV⁺, HBV⁺, markers of HCV or HBV infection (anti-HCV ± HCV RNA; HBV DNA or HBsAg); MPGN, membranoproliferative glomerulonephritis
Major	Mixed cryoglobulins Low C4	Leukocytoclastic vasculitis	Purpura
Minor	Rheumatoid factor HCV⁺, HBV⁺	Clonal B-cell infiltrates (liver and/or bone marrow)	Chronic hepatitis, MPGN, peripheral neuropathy, skin ulcers
“Definite” Mixed Cryoglobulinemia Syndrome serum mixed cryoglobulins (± low C4) + purpura + leukocytoclastic vasculitis serum mixed cryoglobulins (± low C4) + 2 minor clinical symptoms + 2 minor serological/pathologic findings
“Essential” or “secondary” Mixed Cryoglobulinemia:
Absence or presence of well-known disorders (infectious, immunologic, or neoplastic)

Criteria	Serologic	Pathologic	Clinical
Abbreviations: HCV, hepatitis C virus; HBV, hepatitis B virus; HCV⁺, HBV⁺, markers of HCV or HBV infection (anti-HCV ± HCV RNA; HBV DNA or HBsAg); MPGN, membranoproliferative glomerulonephritis
Major	Mixed cryoglobulins Low C4	Leukocytoclastic vasculitis	Purpura
Minor	Rheumatoid factor HCV⁺, HBV⁺	Clonal B-cell infiltrates (liver and/or bone marrow)	Chronic hepatitis, MPGN, peripheral neuropathy, skin ulcers
“Definite” Mixed Cryoglobulinemia Syndrome serum mixed cryoglobulins (± low C4) + purpura + leukocytoclastic vasculitis serum mixed cryoglobulins (± low C4) + 2 minor clinical symptoms + 2 minor serological/pathologic findings
“Essential” or “secondary” Mixed Cryoglobulinemia:
Absence or presence of well-known disorders (infectious, immunologic, or neoplastic)