This protocol applies to patients with essential cryofibrinogenemia characterised by confirmed absence of cryoglobulinaemia, no identified secondary cause of cryofibrinogenaemia, and no evidence of other vaso-occlusive disease.
The previous treatment line used low-dose fibrinolytic therapy — specifically intravenous alteplase or intravenous streptokinase. The intended outcome — clinical improvement with disappearance of plasma cryofibrinogen — was not achieved. This protocol defines the structured next step after that failure.
Management transitions to an oral anabolic agent — stanozolol — as the next therapeutic strategy. Dosing, monitoring, and the full treatment algorithm are available in the complete protocol.
DOI: 10.1093/rheumatology/kew379