Hepatitis C virus infection, type III cryoglobulinemia, and necrotizing vasculitis.
A 53-year-old man with chronic hepatitis-C virus infection presented with livedo reticularis, purpura, and leg ulcers. A skin biopsy specimen showed a necrotizing vasculitis. The skin biopsy specimen and serology confirmed the diagnosis of type-III cryoglobulinemia. Bone marrow and peripheral blood showed proliferation of atypical CD5-positive B cells that included a monoclonal population. There is growing evidence that chronic hepatitis-C infection can result in immune dysregulation and expansion of autoimmune B cells that produce cryoglobulins.
Brownell
Isaac
I
New York University Department of Dermatology, USA.
Fangman
William
W
D018941:Antigens, CD19 / Q000097:blood; D001402:B-Lymphocytes / Q000276:immunology; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology; D018956:CD5 Antigens / Q000097:blood / Q000276:immunology; D003449:Cryoglobulinemia / Q000097:blood / Q000209:etiology* / Q000473:pathology; D003450:Cryoglobulins / Q000378:metabolism; D003937:Diagnosis, Differential; D005434:Flow Cytometry; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000821:virology; D006801:Humans; D016130:Immunophenotyping; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D012367:RNA, Viral / Q000032:analysis; D012867:Skin / Q000473:pathology; D014657:Vasculitis / Q000097:blood / Q000209:etiology* / Q000473:pathology
D018941:Antigens, CD19; D018956:CD5 Antigens; D003450:Cryoglobulins; D012367:RNA, Viral