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血清球蛋白遇冷沉淀,升温后再溶解的现象见于6%的淋巴组织增生、感染、自身免疫紊乱的病人中。特发性混合型冷沉淀蛋白血症(essential mixed cryoglobulinemia),简称EMC,为最多见的亚型。作者报导1例31岁男性,四年前曾诊断为EMCⅡ型。6月前内窥镜发现胃窦及幽门管溃疡。动脉造影见结肠中动脉几个分支闭塞。入院时下肢有疼痛性紫癜,左下腹痛。钡灌肠示乙状结肠有一缩窄,并有溃疡形成,近端横结肠也见一轻度狭窄。远端回肠粘膜皱壁增厚、变直。剖腹探查切除乙状结肠。病理为环周型粘膜溃疡,侵及肌层,肠系膜及肠壁肌性小动脉的内膜和中膜硬化,
The cold precipitation of serum globulin and the phenomenon of re-dissolution after warming are found in 6% of patients with lymphoproliferative, infection, and autoimmune disorders. Idiopathic mixed cryoglobulinemia (EMC) is the most common subtype. The authors report a 31-year-old male who had been diagnosed with the EMC type II four years ago. 6 months before the endoscopy found gastric antrum and pyloric tube ulcers. Arterial angiography showed occlusion of several branches of the middle colon. At the time of admission, there was painful purpura in the lower extremities and pain in the left lower quadrant. Barium enema shows a constriction of the sigmoid colon and ulceration, as well as a mild stenosis in the proximal transverse colon. The ileal mucosa of the distal ileum is thickened and straightened. Laparotomy to remove the sigmoid colon. The pathology is pericyclic mucosal ulcers, invasion of the muscularis, mesentery, and intimal and medial sclerosis of muscular arterioles in the intestinal wall.