How is cryofibrinogenemia treated
Avoiding cold exposure and keeping the patient at 37°C is reasonable, as is smoking cessation if applicable.
Cutaneous lesions should be treated according to standard gangrene or burn protocols. If cryofibrinogenemia is secondary to an underlying disease process such as malignancy, infection, or rheumatic disease, treatment of that condition is typically helpful. It is important to evaluate for potential conditions associated with cryofibrinogenemia.
Among patients with primary cryofibrinogenemia, treatment options are derived primarily from small case series and expert opinion.
Fibrinolytics such as streptokinase and stanozolol have been described as beneficial in some patients. In contrast, experience with heparin has been disappointing, with some patients actually worsening on this therapy. Experience with coumadin is similarly mixed.
Some experts advocate low-dose aspirin therapy (81 mg/day) in conjunction with corticosteroids for patients with mild to moderate symptoms.
Immunosuppression with corticosteroids and agents such as azathioprine, chlorambucil, and cyclophosphamide, have been described in the literature and are likely most appropriately considered in cases associated with an underlying rheumatic disease.
There are limited data to support the use of plasma exchange.
