[Cryoglobulinemia type I and ischemic strokes].

INTRODUCTION: Cryoglobulins are immunoglobulins that persist in the serum, precipitate at the cold temperature and resolubilise when rewarmed. There are three categories, the type I, II and III, with neurological symptoms. Those are dominated by peripheral neuropathy, the central nervous system is generally saved. We reported the case of a cryoglobulinemia of the type I having generated a ischemic cerebrovascular accident (CVA), a seldom described situation.

CASE REPORT: A 62 years old man, without noteworthy past. He allowed for was occurred the functional impotence of the left hemicorp with a discrete left hemiparesis. The cerebral IRM has evoked subacute ischemic cerebrovascular accident. The cardiovascular check-up was normal. The Horton disease was isolated after biopsy of the left temporal artery. The biological check-up objectified indices in favor of a cryoglobulinemia, this one was identified and classified type I. A monoclonal gammopathy of undetermined significance (MGUS) was associated to him.

DISCUSSION: The cutaneous, articular and renal manifestations are the most frequent complications of the cryoglobulinemia, the neurological complications are described, but with a less degree and are dominated by peripheral neuropathy. The attack of the central nervous system remains exceptional and is seen primarily with type I. Its correct assumption of responsibility requires to identify the cryoglobulinemic etiology. Association type I cryoglobulinemia and monoclonal gammapathy reinforced the chances for a central attack.

CONCLUSION: In front of all CVA, it would be judicious to seek a cryoglobulin systematically. A hemopathy is often associated to type I, a electrophoretic exploration of serum proteins is not to be neglected to seek a possible origin of the cryoglobulinemia.