Rituximab Treatment for Recurrent Skin Vasculitis Due to Cryoglobulinemia Associated with Hepatitis C Despite Viral Clearance with Sofosbuvir

ABSTRACT

Hepatitis C (HC) is a major cause of both acute and chronichepatitis. It is a major cause of liver cell failure and its cancer.Nearly 2/3 of patients experience extrahepatic immune-relatedmanifestations including skin vasculitis with/without mixedcryoglobulinemia. Naturally; clearance of viral infection shouldlead to prevention of such complications. Unfortunately; this isnot absolute true. In this case report; we describe a patient,with chronic HC infection yet without chronic liver disease, whocontinued to develop skin vasculitis and cryoglobulinemiadespite virological clearance of RNA virus by Sofosbuvir. Herskin vasculitis improved with yearly Rituximab infusions withoutactivation of hepatitis C infection, other autoimmune diseaseand hepatitis.