Cryoglobulinemia in hepatitis C virus infection

Various extrahepatic manifestations are described during infection by hepatitis C virus [HCV]. They are essentially represented by cryoglobulinemia. We report a case of cryoglobulinemia associated with chronic hepatitis C. A 62 years old woman was hospitalised due to members purpura, associated with peripheral neuropathy localised in lower members. A biologic check-up showed a moderate hepatic cytolysis. A mixed cryoglobulin of type II has been found. Test for antibodies to HCV in serum was positive. HCV RNA was detectable in serum with a low content. The genotype was 2a/2c. Liver biopsy showed active hepatitis. The check-up before the treatment was normal, as well as the renal function. The treatment consisted of the combination of interferon plus ribavirin for 6 months

Plummer-Vinson syndrome [report of two cases]

Plummer-Vinson syndrome is rare. It associates upper dysphagia, cervical oesophageal webs and iron deficiency. We report two cases of this syndrome collected at our department. The first case is a woman, 43 years old, and the second a man of 81 years old, both admitted for upper dysphagia. Biological investigation found iron deficiency anemia. Oesophageal transit disclosed annular stenosis of the cervical segment. Oesogastroduodenal endoscopy performed in the second patient showed regular stenosis. Our two patients beniffited from a pneumatic dilatation under radiological control in one session, iron supplementation was associated. The evolution was common after 2 years. Plummer-Vinson syndrome is rare and affected mainly young women. Its pathophysiology is still unclear. Its diagnosis is based on oesophagel transit and endoscopy. The treatment consist on iron supplementation during 3 months associated to iterative endoscopic dilatations. Pneumatic dilatation under radiological control seem to have good results. The risk of malignant transformation is estimated 10% after 30 to 40 years of evolution, requires rigourous surveillance