Membranoproliferative glomerulonephritis and leukocytoclastic vasculitis without cryoglobulin in chronic hepatitis C virus infection.
The etiopathogenesis of extrahepatic manifestations including vasculitis in the context of HCV infection is still unknown. We report a case with lethal extrahepatic manifestations due to chronic hepatitis C virus (HCV) infection. The patient presented leukocytoclastic vasculitis, sensorimotor neuropathy and membranoproliferative glomerulonephritis with positive rheumatoid factor but lacked cryoglobulin. Hypocomplementaemia and deposition of IgM and C3 in the vascular lesion and glomeruli suggested that immune complex disease played a role in the pathogenesis of extrahepatic manifestations independent of cryoglobulin. Although HCV was successfully eliminated by treatment with interferon alpha, she died of cryptococcal infection.
Nakajima
Ayako
A
Division of Rheumatology, Tokyo Metropolitan Ohtsuka Hospital, Tokyo.
Adachi
Masayuki
M
Tanaka
Michi
M
Suwa
Akira
A
Yasuki
Yoshihiro
Y
Imaeda
Hiroyuki
H
Inada
Shinichi
S
D003450:Cryoglobulins / Q000276:immunology; D003453:Cryptococcosis / Q000150:complications* / Q000276:immunology; D017809:Fatal Outcome; D005260:Female; D015432:Glomerulonephritis, Membranoproliferative / Q000276:immunology*; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000276:immunology; D006801:Humans; D008875:Middle Aged; D009894:Opportunistic Infections / Q000150:complications* / Q000276:immunology; D014657:Vasculitis / Q000276:immunology*
D003450:Cryoglobulins