[Chronic hepatitis C in type-II cryoglobulinemia and cutaneous vasculitis].
Over a period of 2 years recurrent erysipelas-like skin eruptions developed over both lower legs of a 77-year-old woman. On examination there was a vasculitic purpura which histologically was like leukocytoclastic vasculitis. Further tests revealed a positive rheuma factor, a mixed type II cryoglobulinaemia of monoclonal IgM-kappa paraprotein and polyclonal IgG, as well as chronic hepatitis C with viral replication and demonstration of hepatitis C virus-RNA in the cryoprecipitates, diagnostic of chronic hepatitis C with mixed type II cryoglobulinaemia. Treatment was begun with prednisone, 25 mg/d orally, and cyclophosphamide, 100 mg/d orally. Once hepatitis C had been diagnosed, treatment was continued with interferon alpha-2b (initially 3 x 5 mill. IU, later 3 x 3 mill. IU, each weekly subcutaneously). The vasculitis quickly healed and the cryoglobulinaemia had disappeared within 5 weeks. So far, during the treatment of 9 months, the vasculitis has not recurred, but cryoglobulins have again been demonstrated. The signs and symptoms of hepatitis C were not affected by the interferon treatment.
Dumoulin
F L
FL
Allgemeine Innere Medizin, Medizinische Universitätsklinik, Bonn.
Klein
P
P
Fischer
H P
HP
Spengler
U
U
Sauerbruch
T
T
D000368:Aged; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003449:Cryoglobulinemia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005260:Female; D006526:Hepatitis C / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage; D011693:Purpura / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D011994:Recombinant Proteins; D012008:Recurrence; D012074:Remission Induction; D013997:Time Factors; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy
D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins
Chronische Hepatitis C bei Typ-II-Kryoglobulinämie und kutaner Vaskulitis.