Acute renal failure from precipitation of cryoglobulins in a cool operating room.

MEMBERS of surgical teams work for long hours in the operating rooms, dressed in cap, gown, and mask. All too naturally, they prefer an ambient temperature lower than elsewhere in the hospital. Hence, the thermostat is so set in most operating rooms. Cryoglobulinemia is a disorder in which circulating abnormal globulins precipitate in cold. 1,2 The thermal amplitude of cryoglobulins is often low, and symptoms usually occur only at very low temperatures; in some cases, however, the thermal amplitude may be high, covering part of the normal ambient temperature. We describe a patient with cryoglobulinemia of high thermal amplitude. During a surgical procedure in a cool operating room, the cryoglobulins precipitated in the renal vascular system, causing acute renal failure. Report of a Case A 60-year-old woman had pain and swelling of the ankles intermittently for six months. The swelling was associated with fever (to 39.5 °C), erythema, and petechiae