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Clinical ResearchManagement of Hepatitis C Virus-related Mixed Cryoglobulinemia

Management of Hepatitis C Virus-related Mixed Cryoglobulinemia

Mixed cryoglobulinemia is a chronic immune complex-mediated disease strongly associated with hepatitis C virus infection. Clinical features include skin lesions, glomerulonephritis, peripheral neuropathy, and widespread vasculitis.

Abstract
Mixed cryoglobulinemia is a chronic immune complex-mediated disease strongly associated with hepatitis C virus (HCV) infection. Mixed cryoglobulinemia is a vasculitis of small and medium-sized arteries and veins, due to the deposition of complexes of antigen, cryoglobulin and complement in the vessel walls. The main clinical features of mixed cryoglobulinemia vasculitis include the triad of palpable purpura, arthralgias, and weakness, and other pathological conditions such as glomerulonephritis, peripheral neuropathy, skin ulcers, and widespread vasculitis. The treatment of HCV-related mixed cryoglobulinemia is difficult due to the multifactorial origin and clinical polymorphism of the syndrome. It can be directed to eradicate the HCV infection, suppress the B-cell clonal expansion and cryoglobulin production, or ameliorate symptoms. The choice of the most appropriate treatment is strictly related to the assessment of disease activity, and to the extent and severity of organ involvement.

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— F. Iannuzzella, A. Vaglio, G. Garini.

This article originally appeared in the May 2010 issue of The American Journal of Medicine.

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