Cryoglobulinemia related to hepatitis C virus infection
Document Type
Journal Article
Publication Date
4-1-2007
Journal
Digestive Diseases and Sciences
Volume
52
Issue
4
DOI
10.1007/s10620-006-9510-9
Keywords
Autoimmune disorders; Extrahepatic manifestations; Mixed cryoglobulinemia
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. © 2007 Springer Science+Business Media, Inc.
APA Citation
Dore, M., Fattovich, G., Sepulveda, A., & Realdi, G. (2007). Cryoglobulinemia related to hepatitis C virus infection. Digestive Diseases and Sciences, 52 (4). http://dx.doi.org/10.1007/s10620-006-9510-9