Abstract: 【Abstract】Objective To analyze the clinicopathological characteristics in patients with essential and secondary cryoglobulinemia related glomerulonephritis (CGN). Methods A total of 35 patients diagnosed as CGN in Peking University People's Hospital during 2009-2017 were recruited. Their clinical and pathological data were investigated. Results Twenty-three CGN patients with specific causes were divided into secondary CGN group, and 12 patients without any underlying disease were divided into essential CGN group. Extra-renal manifestations were uncommon (0～17.1%) in both groups. The false negative rate of serum cryoglobulin was 48.5%. The decrease of C3 was more common than the decrease of C4. Compared with essential CGN group, more females, higher serum globulin level and lower serum complement levels were found in secondary CGN group. Multiple immune compound deposits were mainly seen in secondary CGN group. Half of the essential CGN patients had a renal pathology manifested as IgA nephropathy. Conclusion ①Since renal involvement in cryoglobulinemia often happened before other organ damages and the result of serum cryoglobulin may be false negative, renal biopsy is a useful tool to confirm the speculation especially to those with negative serum cryoglobulin. ②The decrease of C3 was commonly seen in both groups, indicating that cryoglobulin may not only activate complement by the classical pathway. ③Secondary CGN should be considered in patients with significantly higher globulin level, lower complement level and renal pathological changes characterized by multiple immune compound deposits.

Key words: cryoglobulinemia related glomerulonephritis, essential, secondary, Clinicopathological characteristics