Mixed Cryoglobulinemia: An Unusual Presentation of Hepatitis C

Mebust, Donald P.

doi:10.7812/tpp/12-071

Cited by 1 publication

(1 citation statement)

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“…e role played by HCV in the development of this disease is thought to stem from chronic stimulation of the immune system causing B-cell hyperactivation and selective expansion of cryoglobulin-producing B-cell clones which express rheumatoid factor (RF) and proliferate in the liver, serum, and lymph nodes [4,5]. Circulating cryoglobulins precipitate at low temperatures below 37 degrees Celsius and deposit in small and medium vessels, leading to complement activation and inflammation and subsequently causing systemic vasculitis and damage to various end organs [4]. It is the circulation of these large cryoproteins that leads to increased blood viscosity causing hypoperfusion and subsequently gangrenes [2].…”

Section: Introductionmentioning

confidence: 99%

A Devastating Case of Hepatitis C-Induced Mixed Cryoglobulinemia

Khalid

Alhankawi

Kaur

et al. 2021

Case Reports in Hepatology

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Hepatitis C-induced mixed cryoglobulinemia leading to rapidly progressive gangrene, necessitating amputations, is a rare presentation. We describe a case of a 55-year-old man with untreated chronic hepatitis C virus (HCV) presenting with arthralgia and palpable purpura, which rapidly progressed to life-threatening gangrene of all extremities requiring amputations in the setting of mixed cryoglobulinemia. Treatment for HCV was initiated which led to the arrest of gangrene progression and the patient's survival. Patients with HCV-induced cryoglobulinemia should be closely monitored and started on early therapy with direct-acting antiviral therapy to prevent progression of vasculitis to gangrene. Universal screening for HCV can aid in early diagnosis and treatment to prevent devastating consequences.

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