Cryoglobulinemia is a rare cause of encephalopathy. The authors report thre
e patients with strikingly similar clinical features of recurrent encephalo
pathy accompanied by symptoms of gastrointestinal ischemia. In only one pat
ient was cryoglobulinemia ascertained in life during the final illness. The
autopsy examinations all showed diffuse cerebral, enteral, and systemic sm
all vessel lesions immunoreactive for immunoglobulins and typical of mixed
essential cryoglobulinemia. This unusual relapsing clinical syndrome is rea
dily misinterpreted as of nonorganic origin despite its potentially fatal p
rognosis.