Therapy for hepatitis C virus-related cryoglobulinemic vasculitis.

  title={Therapy for hepatitis C virus-related cryoglobulinemic vasculitis.},
  author={Franco Dammacco and Domenico Sansonno},
  journal={The New England journal of medicine},
  volume={369 11},
Cryoglobulins are present in about a quarter of patients with hepatitis C; in some, cryoglobulinemia can become symptomatic or even life-threatening. This review summarizes evolving therapy for the disorder, including new therapeutic options that are becoming available. 

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A woman admitted to a service for management of acute renal failure and progressive gas-trointestinal symptoms after initiating hepatitis C virus treatment with ribavirin and sofosbuvir is described, sparking suspicion for recurrence of cryo-globulinemic vasculitis.

A Rare Case of Hepatitis C-Associated Cryoglobulinemic Duodenal Vasculitis

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[Cryoglobulinemic vasculitis with renal involvement: A historic aspect of the problem].

The paper shows advances in the study of the etiology of cryoglobulinemia, diagnosis, specific features of renal injury, and current approaches to treating HCV infection-relatedcryoglobulinemic vasculitis with renal involvement, by using 3 clinical cases.

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The prevalence and associations of mixed cryoglobulinemia (MC) in patients with spontaneous clearance of hepatitis C virus (HCV) remain elusive.

A Devastating Case of Hepatitis C-Induced Mixed Cryoglobulinemia

A case of a 55-year-old man with untreated chronic hepatitis C virus presenting with arthralgia and palpable purpura, which rapidly progressed to life-threatening gangrene of all extremities requiring amputations in the setting of mixed cryoglobulinemia is described.

Lymphoma-Associated Monoclonal Cryoglobulinemic Glomerulonephritis and Relationship with Hepatitis C Virus Infection: A Case Report

The case of type I cryoglobulinemic glomerulonephritis in a patient with chronic hepatitis C who presented with acute renal failure exemplifies the crucial role the renal biopsy plays in detecting lymphoid malignancies where clinical features are ambiguous.

A Case of Cryoglobulinemia after Successful Hepatitis C Virus Treatment

It is rare for a patient who achieved sustained virologic response after HCV treatment to develop mixed cryoglobulinemia, and a rare case is presented in a patients who was successfully treated for HCV infection.



Persistent cryoglobulinemic vasculitis following successful treatment of hepatitis C virus.

4 patients who had persistent MC and vasculitis despite successful eradication of HCV with antiviral therapy are described.

Mixed cryoglobulinemia

  • C. Ferri
  • Medicine
    Orphanet journal of rare diseases
  • 2008
The overall prognosis is poorer in patients with renal disease, liver failure, lymphoproliferative disease and malignancies, and the first-line treatment of MC should focus on eradication of HCV by combined interferon-ribavirin treatment.

Rituximab as a Therapeutic Tool in Severe Mixed Cryoglobulinemia

Rituximab appears to be a safe and effective therapeutic option in symptomatic patients with HCV-associated MC with signs of systemic vasculitis and a number of reports published in the last 5 years suggest this.

Hepatitis C virus and alanine aminotransferase kinetics following B-lymphocyte depletion with rituximab: evidence for a significant role of humoral immunity in the control of viremia in chronic HCV liver disease.

The use of the anti-CD20 monoclonal antibody rituximab, which reversibly depletes B cells, in HCV-related mixed cryoglobulinemia afforded an improvement in the clearance of hepatitis C virus from plasma.

The cryoglobulins: an overview

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Safety and efficacy of rituximab in patients with hepatitis C virus-related mixed cryoglobulinemia and severe liver disease.

The depletion of CD20(+) B cells was followed by cirrhosis syndrome improvement despite the possibility of transient increases of viremia titers, and the effectiveness and safety of rituximab in MC syndrome with advanced liver disease were shown.

Relapse of hepatitis C virus-associated mixed cryoglobulinemia vasculitis in patients with sustained viral response.

Relapse of MC vasculitis does occur in a few patients with HCV infection, despite achieving a sustained viral response, and this relapse is not related to persistence of virus.

Efficacy and safety of rituximab in type II mixed cryoglobulinemia.

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