Monitoring
Patients with mixed cryoglobulinemia should be followed clinically and with laboratory testing for evidence of organ involvement. Patients who are asymptomatic or with minimal symptoms should be monitored every 2-3 months for manifestations of cryoglobulinemia such as ulcers, acrocyanosis, digital gangrene, and purpura, and complications of chronic hepatitis C virus infection.
The interval of medical evaluation depends on the previous extent of organ involvement and the relative stability of the patient. Cryoglobulin levels, rheumatoid factor, or complement C4 levels are generally not used to follow up patients because they do not correlate with disease activity.[1][2][4]
Monitoring for malignancies in patients with chronic viral hepatitis is recommended.[55] If a patient is diagnosed with a hematologic malignancy while being evaluated for cryoglobulinemia, referral to a hematologist is imperative.
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