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Wells suspects she was exposed to hepatitis C during the same incident because co-infections were common in those days. But her liver function tests had always been normal. So what exactly was the cause of her symptoms? Wells turned out to have a rare disorder caused by hepatitis C known as Type 2 mixed cryoglobulinemia. It occurs when cryoglobulins - abnormal proteins in the blood - thicken and clump together, restricting coolsculpting blood flow to surrounding organs and causing damage to blood vessels. Cryoglobulins often develop in response to hepatitis C or an autoimmune disorder; roughly half of those with a chronic hepatitis C infection are believed to have cryoglobulins circulating in their blood, but fewer than 30 percent of them develop symptoms. Those signs include fatigue, abdominal pain, weakness, neuropathy and Raynaud's disease, a reaction to cold temperatures or stress that can result in a narrowing of blood vessels. Cryoglobulinemia is three times as common in women as in men. Most cases have been reported in those between ages 40 and 60. "It's the most common manifestation of hep C outside the liver," Nguyen said. "In Europe, it's more commonly recognized." The disorder was overlooked, Nguyen speculated, because Wells' symptoms - abdominal pain, numbness, fatigue - are common to many other diseases. And before Nguyen, no doctor had ever thought to screen Wells for hepatitis C.
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