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Neurology 2000;55:1579-1581
© 2000 American Academy of Neurology
Brief Communications

Relapsing ischemic encephaloenteropathy and cryoglobulinemia

P. G. Ince, MD, FCRPath, P. Duffey, MBBS, MRCP, H. R. Cochrane, MRCPath, J. Lowe, MD, FRCPath and P. J. Shaw, MD, FRCP

From the Departments of Neuropathology (Dr. Ince) and Neurology (Drs. Duffey and Shaw), University of Newcastle upon Tyne; Department of Pathology (Dr. Cochrane), Sunderland General Hospital; and the Department of Neuropathology (Dr. Lowe), Queens Medical Centre, Nottingham, United Kingdom.

Address correspondence and reprint requests to Dr. P.G. Ince, Department of Neuropathology, Newcastle General Hospital, Newcastle upon Tyne, NE4 6BE, UK; e-mail: paulince{at}hamsterley.u-net.com

Cryoglobulinemia is a rare cause of encephalopathy. The authors report three patients with strikingly similar clinical features of recurrent encephalopathy accompanied by symptoms of gastrointestinal ischemia. In only one patient was cryoglobulinemia ascertained in life during the final illness. The autopsy examinations all showed diffuse cerebral, enteral, and systemic small vessel lesions immunoreactive for immunoglobulins and typical of mixed essential cryoglobulinemia. This unusual relapsing clinical syndrome is readily misinterpreted as of nonorganic origin despite its potentially fatal prognosis.–1581




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