Figure 920

Renal syndrome at presentation in patients with cryoglobulinemic glomerulonephritis and associated histologic lesion. During the course of this disease, both the systemic and renal signs may vary remarkably, with periods of exacerbation alternating with periods of quiescence. Very often, exacerbation of the extrarenal signs is associated with exacerbation of renal disease (recurrent episodes of nephritic or nephrotic syndrome); however, a flare-up of renal disease may occur even in the absence of exacerbation of the extrarenal signs. Partial or total prolonged remission occurs spontaneously or after treatment in 10% to 15% of patients. Arterial hypertension frequently is severe and is present in most patients with cryoglobulinemic nephropathy.

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