title: Relapsing polychondritis, chronic hepatitis C virus infection, and mixed cryoglobulemia.
abstract: OBJECTIVE
  Review of relapsing polychondritis (RP) and its association to chronic hepatitis C virus (HCV) infection and mixed cryoglobulinemia.
  
  
  METHODS
  A case of RP associated with HCV infection is reported. The English language medical and scientific literature was reviewed for RP, hepatitis C, and its relation to other connective tissue diseases from February 1966 to January 2003 using MEDLINE.
  
  
  RESULTS
  RP is an uncommon, multisystem disease of unknown etiology characterized by recurrent inflammation of cartilaginous and related tissues, being associated with other diseases in 30% to 35% of cases. HCV infection is a systemic illness with a propensity to trigger or exacerbate autoimmune disorders: eg, essential mixed cryoglobulinemia, membranoproliferative glomerulonephritis, and leukocytoclastic and systemic vasculitis. We could find no previous report of an association between RP with HCV and mixed cryoglobulinemia. Treatment with interferon gamma and ribavirin (IR) not only induced an undetectable viral load, but also resolved symptoms of RP.
  
  
  CONCLUSIONS
  We report a patient with RP, HCV, and mixed cryoglobulinemia. It is unknown if there is a cause-effect or chance relationship. Treatment with IR improved the symptoms of RP. It is not known whether the effects of IR were directly on the RP or suppressed RP indirectly through the actions on the viral load or active hepatitis.
authors.affiliation: Department of Medicine, University of Miami School of Medicine, Miami, FL, USA.
authors.forename: Ivonne
authors.initials: I
authors.lastname: Herrera
authors.forename: Ronald
authors.initials: R
authors.lastname: Concha
authors.forename: Enrique G
authors.initials: EG
authors.lastname: Molina
authors.forename: Eugene R
authors.initials: ER
authors.lastname: Schiff
authors.forename: Roy D
authors.initials: RD
authors.lastname: Altman
mesh_terms: D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D003449:Cryoglobulinemia / Q000188:drug therapy / Q000276:immunology*; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000628:therapy; D011081:Polychondritis, Relapsing / Q000150:complications / Q000175:diagnosis* / Q000276:immunology* / Q000628:therapy; D011241:Prednisone / Q000627:therapeutic use; D012254:Ribavirin / Q000627:therapeutic use
chemical_list: D000893:Anti-Inflammatory Agents; D000998:Antiviral Agents; D012254:Ribavirin; D007372:Interferons; D011241:Prednisone