Chronic hepatitis C virus infection: prevalence of cryoglobulinemia and renal affection in the Egyptian patients

The association between mixed cryoglobulinema [MC], chronic hepatitis C virus [CHC], and renal insufficiency was documented. This paper aimed to determine the prevalence of cryoglobulinemia [CG], and renal affection drug-naive Egyptian patients suffering from CHC-in a cross-sectional study So, 53 patients with CHC and 20 healthy controls were included. Parameters investigated covered; HCV antibodies, HCV RNA, liver profile [AST, ALT, serum albumin, total bilirubin, prothrombin time], renal profile [urea, uric acid, creatinine clearance, urinary albumin], CG, C3, .C4, and three MDRD equations to calculate the GFR. The results showed that CG was found in all patients, but none in controls. The renal markers showed that none of the patients suffered frank nephropathy, but were at increased risk for developing kidney disease

Clinical relevance of cryoglobulinaemia and extrahepatic neurocutaneous manifestations of chronic hepatitis C

To examine the prevalence of cryoglobulinaemia in patients with chronic hepatitis C infection and its relation to extrahepatic neuro-cutaneous manifestations. Forty patients [26 males and 14 females], with clinical, laboratory and histologically established chronic hepatitis C infection, with a mean age of 37.5 years, were submitted to clinical examination, dermatological and neurological evaluation. Neuroimaging as well as neurophysiological evaluation, laboratory assessment including liver function tests, serum cryoprecipitate immunoelectrophoresis, and revision of histopathlogical findings were performed. A high prevalence of cryglobulenemia: 62.5% in patients with chronic hepatitis C infection, the presenting symptoms were fatigue [67.5%], arthralgia [32.5%], paresthesia [30%] and pruritus [25%]; however, there were no statistically significant difference between cryo + ve versus cryo - ve patients except for pruritis, and face pigmentation. Skin manifestations including face pigmentation [42.5%], leukocytoclastic vasculitis [22.5%], porphyria cutanea tarda [20%], lichen planus [17.5%], acral necrolytic erythema [15%] and vitiligo [15%]. Neurological manifestations; symptomatic neuropathy in 10%, neuropathic changes in 30% and electroencephalographic changes in 22.5%. These cutaneous and neurological manifestations were significantly associated with the presence of cryoglobulinaemia. Our findings support an association between cryoglobuliaemia and extrahepatic neurocutaneous manifestations of hepatitis C infection. The presence of all these manifestations in the appropriate clinical setting should suggest the presence of hepatitis C infection

Crioglobulinemia mista em pacientes com infecção pelo vírus da hepatite C (VHC) / Mixed cryoglobulinaemia in patients with hepatitis C virus infection

Introdução: A infecção pelo vírus da hepatite C (VHC) está associada com várias manifestações extra-hepáticas, sendo a patogenia da maior parte baseada em mecanismos autoimunes ou linfoproliferativos. Objetivo: Identificar a prevalência de crioglobulinemia entre os pacientes com infecção pelo VHC. Pacientes e métodos: Foram estudados de forma prospectiva e consecutiva 67 pacientes com hepatite crônica pelo VHC, e avaliados quanto a presença de crioglobulinas, autoanticorpos e quanto a sintomas relacionados a crioglobulinemia. Resultados: Foi detectada a presença de crioglobulinas em 18 pacientes (27%). Quando comparados os pacientes com crioglobulinas com os demais, foi observado sexo feminino: 72% × 51%; média de idade: 49,8± 9,3 × 46,3± 13; nível de ALT: 114,05 × 119,18; genótipo: 1: 67% × 37%; cirrose: 22% × 14%; Artralgia em 39% × 28%; FAN em 11% × 6%; FR em 53% × 29%; anticorpo anti-tireoglobulina em 5% × 8% e anticorpo antimicrossoma em 5% × 2%. A síndrome clínica de crioglobulinemia mista foi diagnosticada em 2 pacientes (11%) e um deles apresentava glomerulonefrite crioglobulinêmica. Conclusão: A prevalência de crioglobulinemia mista em pacientes com infecção pelo VHC é elevada, porém a síndrome clínica é infreqüentemente detectada (AU)

Introduction: The hepatitis C vírus (HCV) infection is associated with many extrahepatic manifestations. The mechanisms are autoimmunes or limphoproliferatives. Objective: To identify the prevalence of cryoglobulinemia in the patients with HCV infection. Pacients and methods: Sixty seven patients with HCV chronic hepatitis were prospectively and consecutively studied. They were evaluated for the presence of cryoglobulins, autoantibodies and symptoms related to cryoglobulins. Results: The presence of cryoglobulins was detected in 18 patients (27%). When this group with cryoglobulins was compared to the others it was observed: women were more prevalent in the cryoglobulin group (72% × 51%); the mean age was 49,8± 9,3 × 46,3± 13; mean ALT was 114,05 × 119,18; genotype ? 1: 67% × 37%; cirrhosis: 22% × 14%; artralgia: 39% × 28%; FAN: 11% × 6%; reumathoid factor: 53% × 29%; anti-thyreoglobulin antibody: 5% × 8%; and anti-microssomal antibody: 5% × 2%. Clinical cryoglobulinemic syndrome was diagnosed in 2 patients (11%) and one of them presented cryoglobulinemic glomerulonephritis. Conclusion: The prevalence of mixed cryoglobulinemia in patients with HCV infection is high, however the clinical syndrome is not frequently detected (AU)