From the Research
Yes, patients with cryoglobulinemia should avoid swimming in cold water. Cold exposure can trigger or worsen symptoms in these patients because cryoglobulins are abnormal proteins in the blood that precipitate or gel at cold temperatures and dissolve again when warmed 1. When a person with cryoglobulinemia is exposed to cold environments, including cold water, these proteins can clump together in small blood vessels, potentially causing pain, purplish skin discoloration (purpura), joint pain, weakness, and in severe cases, tissue damage or organ dysfunction. The severity of reaction depends on the type and concentration of cryoglobulins present.
Key Considerations
- Patients should generally maintain warm body temperatures, especially in extremities, by wearing appropriate clothing in cold weather, avoiding cold food and beverages, and keeping indoor temperatures comfortable.
- If cold exposure does occur and symptoms develop, gradual warming of the affected areas is recommended.
- Patients should discuss specific temperature thresholds and precautions with their healthcare provider, as sensitivity varies between individuals 2.
- Treatment of cryoglobulinemic vasculitis should be modulated according to the underlying associated disease and the severity of organ involvement, and relies on antiviral treatment, immunosuppression, and immunotherapy, particularly anti-CD20 B cell depletion therapies 1.
Management and Treatment
- The therapeutic management of idiopathic cryoglobulinemic vasculitis has yet to be defined, but treatment of severe vasculitis is traditionally based on a combination of corticosteroids and immunosuppressants or plasmapheresis, and more recently rituximab 3.
- Early recognition of the most common clinical presentations, a comprehensive clinical assessment of the different organs that may be affected, and multidisciplinary work led by a unit specialised in systemic autoimmune diseases is essential 1.