Cryoglobulins are abnormal proteins in the blood. If you have cryoglobulinemia (kry-o-glob-u-lih-NEE-me-uh), these proteins may clump together at temperatures below 98.6 F (37 C). These gelatinous protein clumps can impede your blood circulation, which can damage your skin, joints, nerves and organs — particularly your kidneys and liver.

Symptoms usually come and go, and may include:

• Skin lesions. Most people with cryoglobulinemia develop purplish skin lesions on their legs. In some people, leg ulcers also occur.
• Joint pain. Symptoms resembling rheumatoid arthritis are common in cryoglobulinemia.
• Peripheral neuropathy. Cryoglobulinemia can damage the nerves at the tips of your fingers and toes, causing numbness and other problems.

Cryoglobulinemia has been associated with:

• Infections. Hepatitis C is the most common infection associated with cryoglobulinemia. Others include hepatitis B, HIV, Epstein-Barr, toxoplasmosis and malaria.
• Certain cancers. Some cancers of the blood, such as multiple myeloma, Waldenstrom macroglobulinemia and chronic lymphocytic leukemia, can sometimes cause cryoglobulinemia.
• Autoimmune disorders. Disease such as lupus, rheumatoid arthritis and Sjogren's syndrome increase the risk of developing cryoglobulinemia.

Risk factors of cryoglobulinemia may include:

• Your sex. Cryoglobulinemia occurs more frequently in women than in men.
• Age. Symptoms of cryoglobulinemia usually begin in middle age.
• Other diseases. Cryoglobulinemia is associated with diseases such as hepatitis C, HIV, multiple myeloma, Waldenstrom macroglobulinemia, lupus and Sjogren's syndrome.

Diagnosis of cryoglobulinemia involves a blood test in which the sample must be kept at normal body temperature, 98.6 F (37 C), for a period of time before being cooled. Inaccurate test results can occur if the blood sample isn't handled properly.

Depending on the underlying cause of cryoglobulinemia, treatment may include medications that suppress the immune system or fight viral infections. For severe symptoms, your doctor may also recommend a procedure that exchanges your blood plasma, which contains much of the cryoglobulins, for donor plasma or a replacement fluid.

If you have cryoglobulinemia, it's important to avoid exposure to cold — especially to your fingers and toes. You may want to use gloves when using the freezer or refrigerator. Check your feet daily for any injuries, because cryoglobulinemia can make it more difficult for foot injuries to heal.

You may start by seeing your primary care provider. Or you may be referred immediately to a specialist in blood disorders (hematologist).

Here's some information to help you get ready for your appointment.

What you can do

When you make the appointment, ask if there's anything you need to do in advance, such as fasting before having a specific test. Make a list of:

• Your symptoms, including any that seem unrelated to the reason for your appointment
• Key personal information, including major stresses, recent life changes and family medical history
• All medications, vitamins or other supplements you take, including the doses
• Questions to ask your doctor

Take a family member or friend along, if possible, to help you remember the information you're given.

For cryoglobulinemia, some basic questions to ask your doctor include:

• What's likely causing my symptoms?
• Other than the most likely cause, what are other possible causes for my symptoms?
• What tests do I need?
• Is my condition likely temporary or chronic?
• What's the best course of action?
• What are the alternatives to the primary approach you're suggesting?
• I have these other health conditions. How can I best manage them together?
• Are there restrictions I need to follow?
• Should I see a specialist?
• Are there brochures or other printed material I can have? What websites do you recommend?

Don't hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you several questions, such as:

• When did your symptoms begin?
• Have your symptoms been continuous or occasional?
• How severe are your symptoms?
• What, if anything, seems to improve your symptoms?
• What, if anything, appears to worsen your symptoms?

What you can do in the meantime

Avoid doing anything that seems to worsen your signs and symptoms.