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The author describe 2 personal observations of peripheral neuropathy with cryoglobulinemia and the 28 cases previously recorded are reviewed. The characteristics of the usually sensorimotor neuropathy are not specific. Nevertheless, the association with purpura, Raynaud's syndrome and leg ulcers and the inconstant aggravation of the symptoms with cold allow the diagnosis to be suspected on clinical grounds. Cryoglobulin can be recognised by immunoelectrophoresis and classified as type I monoclonal, types II and III mixed and polyclonal. Associated disease should be looked for; lymphocytic proliferation or auto-immune disease. If none is found a diagnosis of essential cryoglobulinemia can be made but with caution as cryoglobulinemia can precede by several years the appearance of associated disease.
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