title: Cryoglobulinemic vasculitis associated with hepatitis C virus infection. A report of eight cases.
abstract: Cryoglobulinemia has an unknown etiology in many cases. In the last years, hepatitis C virus has been known to be involved as a causative agent of so called essential mixed cryoglobulinemia. We report 8 patients suffering from cutaneous vasculitis and chronic hepatitis C virus infection. Their sera showed cryoglobulinemia (6 cases mixed, 2 cases not typified), rheumatoid factor and complement consume. Their hepatitis C virus infection was confirmed by PCR. Hepatitis C virus RNA was found by PCR in 6/6 cryoprecipitates and 5/6 supernatants. The patients were followed for 0.5-12 years. Three of them developed renal affection (2 membranoproliferative glomerulonephritis, 1 not biopsied). Two patients were treated with alpha interferon. One patient noted a marked improvement in her cutaneous vasculitis with interferon treatment, lasting for 18 months after the end of treatment. We recommend the search of hepatitis C virus infection in every case of mixed cryoglobulinemia. Interferon therapy may be useful in some of these cases.
authors.affiliation: Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Revenga Arranz
authors.forename: R
authors.initials: R
authors.lastname: Díaz Díaz
authors.forename: L
authors.initials: L
authors.lastname: Iglesias Díez
authors.forename: B
authors.initials: B
authors.lastname: Cassis Herce
authors.forename: F
authors.initials: F
authors.lastname: Sánchez Gómez
authors.forename: A
authors.initials: A
authors.lastname: Fuertes Ortiz
mesh_terms: D000328:Adult; D000368:Aged; D003165:Complement System Proteins / Q000032:analysis; D003449:Cryoglobulinemia / Q000097:blood / Q000628:therapy / Q000821:virology*; D005260:Female; D005500:Follow-Up Studies; D015432:Glomerulonephritis, Membranoproliferative / Q000821:virology; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000097:blood / Q000628:therapy; D006521:Hepatitis, Chronic / Q000097:blood / Q000628:therapy; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000032:analysis / Q000235:genetics; D012217:Rheumatoid Factor / Q000097:blood; D014657:Vasculitis / Q000097:blood / Q000628:therapy / Q000821:virology*
chemical_list: D016898:Interferon-alpha; D012367:RNA, Viral; D003165:Complement System Proteins; D012217:Rheumatoid Factor