title: Hepatitis C virus infection with and without cryoglobulinemia as a case of Churg-Strauss syndrome.
abstract: Chronic hepatitis C virus (HCV) infection may be associated with numerous immune disorders, with vasculitis including polyarteritis nodosa, or with both. Cryoglobulinemia, which is often present, can also be expressed by vasculitis. We describe 2 cases of Churg-Strauss syndrome (CSS) in patients with HCV infection. We found no previous case of CSS accompanying HCV infection in the literature. The current patients were women aged 40 and 66 years. In both cases, a clinical and laboratory pattern suggesting CSS was found before the HCV infection was discovered. One patient had cryoglobulinemia. One patient was successfully treated with interferon (IFN). The other was treated for 18 months with IFN and corticosteroids. Second-line therapy consisting of IFN with ribavirin was successful. The emergence of HCV infection may have led to an induced form of CSS. The relationship among HCV, cryoglobulinemia, and CSS is not clear, but may be similar to that existing between polyarteritis nodosa and hepatitis B virus. These observations suggest that IFN-alpha therapy may be effective against CSS in HCV infected patients with or without cryoglobulinemia.
authors.affiliation: Clinique de Médecine Interne et Maladies Infectieuses, Hôpital Haut Lévêque, Pessac, France. patrick.mercie@wanado.fr
authors.forename: P
authors.initials: P
authors.lastname: Mercié
authors.forename: J F
authors.initials: JF
authors.lastname: Viallard
authors.forename: I
authors.initials: I
authors.lastname: Faure
authors.forename: P
authors.initials: P
authors.lastname: Trimoulet
authors.forename: A
authors.initials: A
authors.lastname: Vital
authors.forename: F
authors.initials: F
authors.lastname: Lifermann
authors.forename: B
authors.initials: B
authors.lastname: Leng
authors.forename: J L
authors.initials: JL
authors.lastname: Pellegrin
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D015267:Churg-Strauss Syndrome / Q000150:complications* / Q000188:drug therapy; D003449:Cryoglobulinemia / Q000150:complications*; D004359:Drug Therapy, Combination; D005260:Female; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D012254:Ribavirin / Q000627:therapeutic use
chemical_list: D000305:Adrenal Cortex Hormones; D000998:Antiviral Agents; D012254:Ribavirin; D007372:Interferons