title: Hepatitis C virus positive patient diagnosed after detection of atypical cryoglobulin.
abstract: A 60-year-old male patient presented with jaundice and dark urine for three days, icteric sclerae and skin rash on his legs for six months. Laboratory investigations revealed an atypical cryoglobulinemia with high hepatitis C virus (HCV)-RNA levels. Imaging studies showed cholestasis was accompanying HCV. Capillary zone electrophoresis using immunosubtraction method revealed a polyclonal immunoglobulin G and immunoglobulin A (IgA) monoclonal cryoglobulin and that IgA lambda was absent in immunofixation electrophoresis. After a liver biopsy, chronic hepatitis C, HCV related mixed cryoglobulinemia and cryoglobulinemic vasculitis were diagnosed and antiviral therapy was initiated. Our HCV patient presented with cryoglobulinemic symptoms with an atypical cryoglobulinemia that was detected by an alternative method: Immunosubtraction by capillary electrophoresis. Different types of cryoglobulins may therefore have a correlation with clinical symptoms and prognosis. Therefore, the accurate immunotyping of cryoglobulins with alternative methods may provide more information about cryoglobulin-generated pathology.
authors.affiliation: Belkiz Ongen, Fehime Benli Aksungar, Isin Akyar, Abdurrahman Coskun, Mustafa Serteser, Ibrahim Unsal, Department of Biochemistry, Acibadem Labmed Clinical Laboratories, 34435 Istanbul, Turkey.
authors.forename: Belkiz
authors.initials: B
authors.lastname: Ongen
authors.affiliation: Belkiz Ongen, Fehime Benli Aksungar, Isin Akyar, Abdurrahman Coskun, Mustafa Serteser, Ibrahim Unsal, Department of Biochemistry, Acibadem Labmed Clinical Laboratories, 34435 Istanbul, Turkey.
authors.forename: Fehime Benli
authors.initials: FB
authors.lastname: Aksungar
authors.affiliation: Belkiz Ongen, Fehime Benli Aksungar, Isin Akyar, Abdurrahman Coskun, Mustafa Serteser, Ibrahim Unsal, Department of Biochemistry, Acibadem Labmed Clinical Laboratories, 34435 Istanbul, Turkey.
authors.forename: Bahattin
authors.initials: B
authors.lastname: Cicek
authors.affiliation: Belkiz Ongen, Fehime Benli Aksungar, Isin Akyar, Abdurrahman Coskun, Mustafa Serteser, Ibrahim Unsal, Department of Biochemistry, Acibadem Labmed Clinical Laboratories, 34435 Istanbul, Turkey.
authors.forename: Isin
authors.initials: I
authors.lastname: Akyar
authors.affiliation: Belkiz Ongen, Fehime Benli Aksungar, Isin Akyar, Abdurrahman Coskun, Mustafa Serteser, Ibrahim Unsal, Department of Biochemistry, Acibadem Labmed Clinical Laboratories, 34435 Istanbul, Turkey.
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Coskun
authors.affiliation: Belkiz Ongen, Fehime Benli Aksungar, Isin Akyar, Abdurrahman Coskun, Mustafa Serteser, Ibrahim Unsal, Department of Biochemistry, Acibadem Labmed Clinical Laboratories, 34435 Istanbul, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Serteser
authors.affiliation: Belkiz Ongen, Fehime Benli Aksungar, Isin Akyar, Abdurrahman Coskun, Mustafa Serteser, Ibrahim Unsal, Department of Biochemistry, Acibadem Labmed Clinical Laboratories, 34435 Istanbul, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Unsal
keywords: Cryoglobulinemia; Electrophoresis; Hepatitis C; Immunosubtraction; Immunotyping