title: Waldenström macroglobulinemia in hepatitis C: case report and review of the current literature.
abstract: Background. Recent literature has associated hepatitis C virus with the development of non-Hodgkin lymphoma. Hepatitis C virus infection appears to promote lymphoproliferation, providing a plausible mechanism for a causative association; however, despite prior reports of patients with comorbid hepatitis C infection and Waldenström macroglobulinemia, the literature is in disagreement regarding whether there exists an association between these two conditions. Case Presentation. This case report describes a 57-year-old African-American male with chronic hepatitis C infection and cryoglobulinemia who presented with several episodes of transient confusion and paralysis and was found to have symptomatic hyperviscosity. The recognition of his condition was facilitated by characteristic findings on ophthalmologic examination. He was subsequently diagnosed with Waldenström macroglobulinemia on bone marrow biopsy. Conclusions. An up to date, comprehensive review of the literature suggests an association between hepatitis C and Waldenström macroglobulinemia. Data on optimal treatment of patients with comorbid hepatitis C infection and Waldenström macroglobulinemia is limited. We have provided a comprehensive review of previously explored treatment options to guide management of other similar patients. Our patient has since been treated with repeated plasmapheresis with a plan to pursue antiviral therapy.
authors.affiliation: Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA.
authors.forename: Ryan
authors.identifier: 0000-0002-4577-3248
authors.initials: R
authors.lastname: Nipp
authors.affiliation: Department of Medicine, Duke University Medical Center, 2301 Erwin Road, P.O. Box 3422, Durham, NC 27710, USA ; Internal Medicine Residency Office, Duke University Hospital, 2301 Erwin Road, Durham, NC 27710, USA.
authors.forename: Aaron
authors.identifier: 0000-0003-3639-3515
authors.initials: A
authors.lastname: Mitchell
authors.affiliation: Department of Medicine, Duke University Medical Center, 2301 Erwin Road, P.O. Box 3422, Durham, NC 27710, USA ; Internal Medicine Residency Office, Duke University Hospital, 2301 Erwin Road, Durham, NC 27710, USA.
authors.forename: Allyson
authors.identifier: 0000-0001-9997-454X
authors.initials: A
authors.lastname: Pishko
authors.affiliation: Department of Medicine, Duke University Medical Center, 2301 Erwin Road, P.O. Box 3422, Durham, NC 27710, USA.
authors.forename: Ara
authors.initials: A
authors.lastname: Metjian