Cryoglobulinemia Related to Hepatitis C Virus Infection

Maria Dore; Giovanna Fattovich; Antonia Sepulveda; Giuseppe Realdi
April 2007
Digestive Diseases & Sciences;Apr2007, Vol. 52 Issue 4, p897
Academic Journal
Abstract  A causal link among hepatitis C virus (HCV) infection and essential mixed cryoglobulinemia, cryoglobulinemic glomerulonephritis, and vasculitis is strongly supported. HCV triggers autoimmune response in predisposed individuals that manifests as organ-specific and non–organ-specific autoantibodies and as polyclonal/monoclonal rheumatoid factor, which has a central role in causing damaging cryoglobulin and immune complex tissue levels. Immunologic events are mainly induced by HCV infection persistence, with excessive immune stimulation. Humoral immune dysfunction leads to autoantibodies and rheumatoid factor production with cryoglobulinemia, glomerulonephritis, vasculitis, neuropathy, and probably thyroiditis, and arthritis in rare cases. Cellular immune dysfunction leads to lymphocytic infiltration, proliferation, and cytokine production. Pegylated (or not) interferon-alpha in combination with ribavirin appears to be the treatment of choice for patients with symptomatic essential mixed cryoglobulinemia with or without glomerulonephritis. Novel treatment with rituximab is promising.


Related Articles

  • Hepatitis C virus infection, cryoglobulinaemia, and beyond. A. Carbone; V. De Re // Rheumatology;Apr2007, Vol. 46 Issue 4, p572 

    Hepatitis C virus (HCV) infection is the major cause of mixed cryoglobulinaemia (MC), an immune complex (IC)-mediated systemic vasculitis mainly involving the small blood vessels. The precise mechanism of cryoprotein production is currently unknown. HCV virions and non-enveloped core protein...

  • Mixed cryoglobulinemia: new concepts. Ramos-Casals, Manuel; Trejo, Olga; Garcia-Carrasco, Mario; Cervera, Ricard; Font, Josep // Lupus;2000, Vol. 9 Issue 2, p83 

    The most documented extrahepatic manifestation of hepatitis C virus (HCV) infection is mixed cryoglobulinemia (MC). MC is characterised by the presence of temperature-sensitive protein complexes: in type II MC, cryoglobulins are composed of a monoclonal rheumatoid factor (usually, IgM?) against...

  • A Case of Cryoglobulinemic Membranoproliferative Glomerulonephritis Induced by Hepatitis C Virus. Tomoyuki Otsuka; Yukinao Sakai; Dai Ohno; Shuichi Tsuruoka // Journal of Nippon Medical School;2015, Vol. 82 Issue 4, p193 

    A 61-year-old man with bilateral purpura of the lower limbs and subsequent edema, was hospitalization after renal dysfunction developed. The presence of hepatitis C virus (HCV) RNA and cryoglobulin and the finding of membranoproliferative glomerulonephritis on renal biopsy led to a diagnosis of...

  • HCV core protein affected mixed cryoglobulinemia patients based on genotype.  // Infectious Disease News;Apr2014, Vol. 27 Issue 4, p25 

    The article discusses a study led by Sabino Russi, published in the March 18, 2014 issue of the journal "Arthritis Research and Therapy," on hepatitis C virus (HCV) core protein's effect on the cold-precipitation process in a virus genotype-dependence in HCV-related mixed cryoglobulinemia patients.

  • Mixed cryoglobulinaemia: a cross-road between autoimmune and lymphoproliferative disorders. Ferri, C.; La Civita, L.; Longombardo, G.; Zignego, A.L.; Pasero, G. // Lupus;1998, Vol. 7 Issue 4, p275 

    Mixed cryoglobulinaemia (MC) is a systemic vasculitis, secondary to the deposition in small and medium-sized blood vessels of circulating immune complexes, mainly the cryoglobulins, and complement. MC is characterised by a typical clinical triad (purpura, weakness, arthralgias) and by one or...

  • CRIOGLOBULINÉMA MISTA. Roque, R.; Ramiro, S.; Vinagre, F.; Cordeiro, A.; Godinho, F.; Santos, M. J.; Gonçalves, P.; Canas da Silva, J. // Acta Reumatológica Portuguesa;jul-sep2011, Vol. 36 Issue 3, p298 

    The authors describe two clinical cases of cryoglobulinemia. A 70 years old woman, having skin ulcers on lower limbs, arthralgias, paresthesias and constitutional symptoms, for about 10 months. Exams revealed mild anemia, elevation of the biological parameters of inflammation and...

  • Genome-wide association study of hepatitis C virus- and cryoglobulin-related vasculitis. Zignego, A L; Wojcik, G L; Cacoub, P; Visentini, M; Casato, M; Mangia, A; Latanich, R; Charles, E D; Gragnani, L; Terrier, B; Piazzola, V; Dustin, L B; Khakoo, S I; Busch, M P; Lauer, G M; Kim, A Y; Alric, L; Thomas, D L; Duggal, P // Genes & Immunity;Oct/Nov2014, Vol. 15 Issue 7, p500 

    The host genetic basis of mixed cryoglobulin vasculitis is not well understood and has not been studied in large cohorts. A genome-wide association study was conducted among 356 hepatitis C virus (HCV) RNA-positive individuals with cryoglobulin-related vasculitis and 447 ethnically matched, HCV...

  • Hepatitis C virus: A rare manifestation - Remitting relapsing central and peripheral demyelination. Escorcio Bezerra, Marcio Luiz; Harumi, Juliana Arita; Morais Shinosaki, Jullyanna Sabrysna; Pedroso, José Luiz; Henriques de Aquino, Camila Catherine; de Souza, Larissa Teles; Baiense, Robson Fantinato; de Oliveira, Acary Souza Bulle // Neurology India;Jan2011, Vol. 59 Issue 1, p114 

    The most frequent neurologic manifestations of hepatitis C virus infection include peripheral neuropathy axonal type and central nervous system (CNS) vasculitis. Affected patients usually have cryoglobulinemia and other signs of vasculitis. Demyelinating lesions, both central and peripheral are...

  • Purpura and serum mixed cryoglobulinemia in psoriatic arthritis. Palazzi, Carlo; D'Amico, Emilio; Pennese, Ernesta; Petricca, Attilio; Olivieri, Ignazio // Rheumatology International;Dec2006, Vol. 27 Issue 2, p187 

    We here firstly describe the case of a psoriatic arthritis associated with cutaneous purpura and lower limbs weakness. The presence of type III mixed cryoglobulinemia in serum was the only possible detected cause. Discrepancies with the hepatitis C virus-related mixed cryoglobulinemia picture...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics