Cryoglobulinemia physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Feham Tariq, MD [2]

Physical Examination

• Physical examination of patients with [disease name] is usually remarkable for: purpura, arthralgia, and

Appearance of the Patient

• Patients with cryoglobulinemia usually appear normal. Clinical manifestations that appear vary according to the type of cryoglobulinemia. The various signs that appear are most commonly due to underlying hyperviscosity and thrombosis.

Vital Signs

Vital signs in patients with cryoglobulinemia are normal.

Skin

• Raynauds phenomenon
• Livedo reticularis
• Palpable purpura
• Digital ischemia
• Acrocyanosis

• Description (Adapted from Dermatology Atlas)

  Description (Adapted from Dermatology Atlas)

• 

  Description (Adapted from Dermatology Atlas)

HEENT

• Nystagmus
• Retinal hemorrhage

Neck

• Lymphadenopathy

Lungs

• Pulmonary examination of patients with [disease name] is usually normal.

OR

• Asymmetric chest expansion / Decreased chest expansion
• Lungs are hypo/hyperresonant
• Fine/coarse crackles upon auscultation of the lung bases/apices unilaterally/bilaterally
• Rhonchi
• Vesicular breath sounds / Distant breath sounds
• Expiratory/inspiratory wheezing with normal / delayed expiratory phase
• Wheezing may be present
• Egophony present/absent
• Bronchophony present/absent
• Normal/reduced tactile fremitus

Heart

• Cardiovascular examination of patients with cryoglobulinemia is usually normal.

Abdomen

• Hepatomegaly
• Splenomegaly

Back

• Back examination of patients with cryoglobulinemia is usually normal.

Genitourinary

• Hematuria

Neuromuscular

• Headache
• Dizziness
• Ataxia
• Confusion
• Dementia
• Stroke
• Coma

Extremities

Extremities examination of patients with cryoglobulinemia usually have the following findings:

• Digital ischemia/gangerene
• Fasciculations in the upper/lower extremity
• Joint imvolvement most commonly in knees, ankles, proximal interphalangeal joints.
• Peripheral neuropathy

References

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