Successful management of neonatal cryoglobulinaemia after a gemellar pregnancy in a woman with symptomatic type I cryoglobulinaemia

Osteoprotegerin (OPG) is a soluble decoy receptor, produced by osteoblastic cells and in the inflamed synovium of RA by dendritic cells, B cells, and other immunocompetent cells.1,2 It inhibits the differentiation of osteoclast precursor cells and the activation of mature osteoclasts by neutralising the receptor activator of NF-κB ligand (RANKL).3 RANKL, a member of the tumour necrosis factor family, is expressed on prae-osteoblasts and T lymphocytes. A soluble RANKL (sRANKL) can be produced by activated T lymphocytes or can be generated from the cell bound form by a protease. RANKL itself activates a receptor activator of NF-κB (RANK).4 RANKL, together with monocyte-colony stimulating factor, interleukin 1, and RANK is responsible for osteoclast formation and activation and inhibits …