Cryoglobulinemia in chronic liver diseases: Role of hepatitis C virus and liver damage

Lunel, F.; Musset, Lucile; Cacoub, P.; Frangeul, Lionel; Cresta, Pascale; Perrin, M.; Grippon, P.; Hoang, Catherine; Pietté, J.C.; Huraux, Jean‐Marie; Opolon, P

doi:10.1016/0016-5085(94)90022-1

Cited by 429 publications

(270 citation statements)

References 55 publications

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“…9,13,20,21,22,23 Various extrahepatic manifestations have been associated with HCV, such as cryoglobulinemia, glomerulonephritis, neuropathy, as well as autoimmune diseases such as vasculitis, rheumatoid arthritis, systemic lupus erythematosus, polymyositis/dermatomyositis, thyroid disease and monoclonal gammopathy. 15,21,24,25,26 The mechanisms by which viruses in general, and HCV in particular, trigger or enhance autoimmunity can be explained in various ways.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Autoantibodies in Patients with Hepatitis C Virus Infection in Oman

Alnaqdy¹,

Alfahdi²,

Al-Kobaisi³

et al. 2003

Ann Saudi Med

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Background: HCV genotype patterns and HLA types in the Omani population may be unique. Subjects and Methods: Tests for 12 different autoantibodies were carried out on 50 HCV-infected patients and on 27 HCV-seronegative controls. An immunoassay for the detection of anti-HCV antibodies was performed on patient and control sera. HCV PCR was carried out on those sera which were positive for HCV antibodies. Results: All patients' sera were positive for HCV antibodies and all control sera were negative. Sixty-six percent of patients were positive for at least one autoantibody. In contrast, only 33% of the controls showed positivity for one or more autoantibodies. Conclusion: This study found a significant difference in the prevalence of autoantibodies between patients and controls, and between organ-and non-organ specific autoantibodies among the patients. A comparison with autoantibody patterns reported for HCV-infected patients in other parts of the world suggest that patterns in HCVinfected individuals in the Omani population are unique.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Autoantibodies in Patients with Hepatitis C Virus Infection in Oman

Alnaqdy¹,

Alfahdi²,

Al-Kobaisi³

et al. 2003

Ann Saudi Med

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“…Among them, cryoglobulin is a crucial biological manifestation which is present in 47-56 % of HCV-positive patients (1)(2)(3). Not all cryoglobulinpositive patients are symptomatic but cryoglobulin-positive patients tend to have severe immunological abnormalities (3).…”

Section: Introductionmentioning

confidence: 99%

Membranoproliferative Glomerulonephritis and Leukocytoclastic Vasculitis without Cryoglobulin in Chronic Hepatitis C Virus Infection

et al. 2003

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The etiopathogenesis of extrahepatic manifestations including vasculitis in the context of HCVinfection is still unknown. Wereport a case with lethal extrahepatic manifestations due to chronic hepatitis C virus (HCV) infection. The patient presented leukocytoclastic vasculitis, sensorimotor neuropathy and membranoproliferative glomerulonephritis with positive rheumatoid factor but lacked cryoglobulin. Hypocomplementaemia and deposition of IgM and C3 in the vascular lesion and glomeruli suggested that immune complex disease played a role in the pathogenesis of extrahepatic manifestations independent of cryoglobulin. Although HCVwas successfully eliminated by treatment with interferon a, she died of cryptococcal infection.

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“…3,4 Although cryoglobulin is detectable in 40% to 60% of patients with chronic hepatitis C, only 10% to 15% of them will develop symptomatic cryoglobulinemia. Patients with chronic hepatitis C and cryoglobulin have been reported to have a higher incidence of cirrhosis 5,6 and increased fibrosis score 4 compared with patients without cryoglobulin; however, this matter is still controversial. Additionally, there are no large comparison studies to assess severity of liver disease according to the presence of symptomatic or asymptomatic cryoglobulin.…”

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confidence: 99%

Cryoglobulinemia is associated with steatosis and fibrosis in chronic hepatitis C†

et al. 2006

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The relationship between cryoglobulin and severity of liver lesions is debated. No study has focused on the relationship between cryoglobulin, liver steatosis, and fibrosis. The aim of this study was to determine the relationship between cryoglobulins and liver lesions (necroinflammation, fibrosis, and steatosis) in patients with hepatitis C virus (HCV) infection. Four hundred and thirty-seven consecutive patients with untreated chronic hepatitis C who had been admitted for liver biopsy were included in the study. Risk factors for fibrosis and steatosis were assessed. The mean age was 50.9 ؎ 13.8 years, and 49% were male. Cryoglobulin was present in 286 patients, 103 of whom had vasculitis. One hundred and eighty-six patients (43%) had steatosis greater than 10%, and 110 (25%) had advanced fibrosis (Metavir score F3-F4). On multivariate analysis, cryoglobulin increased by nearly threefold the risk of having advanced fibrosis and steatosis greater than 10%. Steatosis greater than 10% was associated with a higher body mass index (P < .001), HCV genotype 3 (P < .001), cryoglobulin (P ‫؍‬ .002), and advanced liver fibrosis (P ‫؍‬ .009). Advanced fibrosis (F3-F4) was associated with a higher level of ␥-glutamyltransferase (P ‫؍‬ .04), cryoglobulin (P < .001), a high grade of necroinflammation (Metavir score A2-A3) (P < .001), and steatosis higher than 10% (P ‫؍‬ .04). In conclusion, our study shows an independent association between cryoglobulin and steatosis as well as advanced fibrosis. (HEPATOLOGY 2006;43: 1337-1345.)

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Cryoglobulinemia in chronic liver diseases: Role of hepatitis C virus and liver damage

Cited by 429 publications

References 55 publications

Prevalence of Autoantibodies in Patients with Hepatitis C Virus Infection in Oman

Prevalence of Autoantibodies in Patients with Hepatitis C Virus Infection in Oman

Membranoproliferative Glomerulonephritis and Leukocytoclastic Vasculitis without Cryoglobulin in Chronic Hepatitis C Virus Infection

Cryoglobulinemia is associated with steatosis and fibrosis in chronic hepatitis C†

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