title: Purpura with cold urticaria in a patient with hepatitis C virus infection-associated mixed cryoglobulinemia type III: successful treatment with interferon-beta.
abstract: We describe a 54-year-old man with hepatitis C virus (HCV) infection-associated cryoglobulinemia type III. The patient had suffered from cold-induced urticaria that left purpuric eruptions up to 1 cm in diameter, intermittent migratory joint pain for seven years and mild liver dysfunction for nine years. Hemophilia A was diagnosed when the patient was 26 years old, and he was then given infusions of factor VIII for a short time. In both skin biopsy samples from urticarial and purpuric eruptions, mild inflammatory infiltration by polymorphonuclear leukocytes with nuclear dust, extravasation of erythrocytes and deposition of IgM and C3 in the superficial blood vessels were observed. After antiviral treatment with interferon-beta, the clinical symptoms and the cryoglobulin and HCV-RNA in the serum disappeared. There has been no recurrence in the subsequent nine years.
authors.affiliation: Department of Dermatology, Niigata University School of Medicine, Niigata, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Ito
authors.forename: Takashi
authors.initials: T
authors.lastname: Kazama
authors.forename: Kaoru
authors.initials: K
authors.lastname: Ito
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ito
mesh_terms: D001707:Biopsy, Needle; D003449:Cryoglobulinemia / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D005500:Follow-Up Studies; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007150:Immunohistochemistry; D016899:Interferon-beta / Q000627:therapeutic use*; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D011693:Purpura / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D018570:Risk Assessment; D016896:Treatment Outcome; D014581:Urticaria / Q000150:complications / Q000188:drug therapy* / Q000473:pathology
chemical_list: D016899:Interferon-beta