[Fibrosing alveolitis with hepatitis C-related cryoglobulinemia].
METHODS
A 56-year-old man presented with fever, myalgia and weakness of the limbs for four weeks. The physical examination showed a skin rash, hepatomegaly and reduced mobility of the limbs due to pain.


METHODS
Laboratory tests revealed an elevated rheumatoid factor, cryoglobulins and were positive for hepatitis C-antibodies. The lung function tests indicated mild obstruction and a moderate decrease of diffusion capacity. Bronchoalveolar lavage showed lymphocytic alveolitis. Computed tomography of the thorax revealed mediastinal lymphadenopathy, diffuse ground-glass infiltrates and bilateral signs of fibrosis in the lower lung fields.


METHODS
Because of the fibrosing alveolitis associated with hepatitis C-related cryoglobulinemia, immunosuppression was started with high-dosage prednisone and azathioprine. The symptoms improved on this treatment.


CONCLUSIONS
Hepatitis C-related cryoglobulinemia is a rare condition that usually presents with nonspecific symptoms. Severe pulmonary involvement is very uncommon. There are no general guidelines about treatment.
Witte
L
L
Medizinische Klinik III, Universität zu Lübeck.
Rupp
J
J
Heyer
P
P
Dalhoff
K
K
Schaaf
B
B
D001379:Azathioprine / Q000627:therapeutic use; D018893:Bronchoalveolar Lavage; D003449:Cryoglobulinemia / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D003450:Cryoglobulins / Q000032:analysis; D005938:Glucocorticoids / Q000627:therapeutic use; D006526:Hepatitis C / Q000150:complications* / Q000175:diagnosis; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008168:Lung / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D011658:Pulmonary Fibrosis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D013902:Radiography, Thoracic; D012129:Respiratory Function Tests; D012217:Rheumatoid Factor / Q000097:blood; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D003450:Cryoglobulins; D005938:Glucocorticoids; D018937:Hepatitis C Antibodies; D007166:Immunosuppressive Agents; D012217:Rheumatoid Factor; D011239:Prednisolone; D001379:Azathioprine