What is the prognosis of mixed cryoglobulinemic vasculitis?
Approximately 65% have a slow, relatively benign course, and 35% have a moderate-to-severe course. Survival over 10 years is 56% in mixed cryoglobulinemic vasculitis versus 93% in controls.
Renal involvement most strongly confers a worse prognosis: 62% survival without renal involvement versus 33% survival with renal involvement. In addition, male sex, age ≥60 years, type II MC, gastrointestinal involvement, chronic HCV infection, and diffuse vasculitis are also risk factors.
Complement values, RF titers, and cryoglobulin levels have no prognostic significance. The lack of association between cryoglobulin levels and prognosis is important to note, as low cryoglobulin concentration (in the correct clinical context) can be associated with severe disease and should not be easily dismissed.
Renal failure is the most common cause of death, whereas cirrhosis, widespread vasculitis, malignancy, and infection are less frequent causes.
