Hepatic biopsy showed either persistent or aggressive chronic hepatitis in 11 patients with cryoglobulinaemia not attributable to known disease entities, whereas liver impairment was not in every case suggested by either physical examination or functional abnormalities. The incidence was predominantly in women and cryoglobulin behaviour was similar in these patients and in five subjects with cirrhosis-associated cryoglobulinaemia. It is concluded that liver disease should be included among the constant features of the cryoglobulin-associated syndrome, and the speculation is advanced that in cryoglobulinaemic patients both cirrhosis and chronic hepatitis may be caused by the same pathogenic mechanism(s).
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