Vasculitic multiplex mononeuritis: polyarteritis nodosa versus cryoglobulinemic vasculitis.
A 76-year-old female patient presented with a progressive motor-sensory multiplex mononeuritis (MM). Combined muscle and nerve biopsy showed the typical findings of a polyarteritis nodosa (PAN). Despite treatment with corticosteroids paresthesias increased and purpura of the legs newly appeared. Hepatitis screening revealed chronic hepatitis C-infection associated with cryoglobulinemia Type II (IgM-kappa Ig A). Finally, we diagnosed a hepatitis C-associated cryoglobulinemic vasculitis based on clinical and laboratory findings.
Steidl
Corinna
C
Alfried-Krupp-Krankenhaus, Essen, Germany. costeidl@gmx.de
Baumgaertel
Martin W
MW
Neuen-Jacob
Eva
E
Berlit
Peter
P
D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D001706:Biopsy; D003449:Cryoglobulinemia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000821:virology; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D020422:Mononeuropathies / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000821:virology; D010291:Paresis / Q000209:etiology; D010488:Polyarteritis Nodosa / Q000150:complications* / Q000175:diagnosis; D011693:Purpura / Q000209:etiology; D012678:Sensation Disorders / Q000209:etiology; D016896:Treatment Outcome; D014657:Vasculitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000821:virology
D000998:Antiviral Agents; D007166:Immunosuppressive Agents
Arthritis Rheum. 2005 Mar;52(3):911-5
15751068
J Hepatol. 2005 May;42(5):632-8
15826710
Clin Exp Rheumatol. 2003 Nov-Dec;21(6 Suppl 32):S78-84
14740431
Ann Rheum Dis. 2003 Dec;62(12):1230-3
14644867
Lancet Infect Dis. 2005 Apr;5(4):227-36
15792740
Medicine (Baltimore). 2005 Sep;84(5):313-322
16148731
Semin Arthritis Rheum. 2004 Jun;33(6):355-74
15190522
J Rheumatol. 2000 Sep;27(9):2172-8
10990230
Curr Opin Rheumatol. 2007 Jan;19(1):33-8
17143093
Arthritis Rheum. 1990 Aug;33(8):1088-93
1975174
Curr Opin Rheumatol. 2006 Jan;18(1):54-63
16344620
J Am Acad Dermatol. 1991 Jul;25(1 Pt 1):21-7
1880249
Springer Semin Immunopathol. 1997;19(1):111-29
9266635
Am J Med. 1966 Jun;40(6):837-56
4956871
Am J Med. 1974 Nov;57(5):775-88
4216269