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Cryoglobulin

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https://www.readbyqxmd.com/read/28339354/the-effects-of-an-educational-meeting-and-subsequent-computer-reminders-on-the-ordering-of-laboratory-tests-by-rheumatologists-an-interrupted-time-series-analysis
#1
Nienke Lesuis, Nathan den Broeder, Nadine Boers, Ester Piek, Steven Teerenstra, Marlies Hulscher, Ronald van Vollenhoven, Alfons A den Broeder
OBJECTIVES: To examine the effects of an educational meeting and subsequent computer reminders on the number of ordered laboratory tests. METHODS: Using interrupted time series analysis we assessed whether trends in the number of laboratory tests ordered by rheumatologists between September 2012 and September 2015 at the Sint Maartenskliniek (the Netherlands) changed following an educational meeting (September 2013) and the introduction of computer reminders into the Computerised Physician Order Entry System (July 2014)...
March 23, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28332476/new-onset-hepatitis-c-virus-associated-glomerulonephritis-following-sustained-virologic-response-with-direct-acting-antiviral-therapy%C3%A2
#2
Muriel Ghosn, Matthew B Palmer, Catherine E Najem, Danny Haddad, Peter A Merkel, Jonathan J Hogan
Glomerulonephritis (GN) is an important extra-hepatic manifestation of infection with hepatitis C virus (HCV). HCV-associated GN occurs due to HCV-induced lymphoproliferation, leading to the generation of pathogenic immune complexes, including complexes containing cryoglobulins. The management of HCV-associated extra-hepatic disease is focused on viral eradication, with direct-acting antiviral agents leading to high rates of sustained virologic remission. There have been a few reports of relapsing cryoglobulinemic vasculitis after sustained virologic remission was achieved with interferon-based therapies...
March 23, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28291241/efficacy-and-safety-of-direct-acting-antivirals-for-the-treatment-of-mixed-cryoglobulinemia
#3
Joel S Emery, Magdalena Kuczynski, Danie La, Saeed Almarzooqi, Matthew Kowgier, Hemant Shah, David Wong, Harry L A Janssen, Jordan J Feld
OBJECTIVES: Mixed cryoglobulinemia is strongly associated with hepatitis C virus (HCV) infection and ranges from being asymptomatic to causing life-threatening vasculitis. In those with symptoms, treatment with pegylated interferon (pegIFN) and ribavirin (RBV) reduces mortality. However, few data are available on the safety and efficacy of antiviral therapy with direct acting antivirals (DAAs) in the treatment of HCV-related cryoglobulinemia. METHODS: Patients treated for HCV-related cryoglobulinemia with DAA±pegIFN were retrospectively evaluated at a tertiary care center...
March 14, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28288791/efficacy-and-safety-of-sofosbuvir-plus-daclatasvir-for-treatment-of-hcv-associated-cryoglobulinemia-vasculitis
#4
David Saadoun, Stanislas Pol, Yasmina Ferfar, Laurent Alric, Christophe Hezode, Si Nafa Si Ahmed, Luc de Saint Martin, Cloé Comarmond, Anne Sophie Bouyer, Lucile Musset, Thierry Poynard, Matthieu Resche Rigon, Patrice Cacoub
Circulating mixed cryoglobulins are detected in 40%-60% of patients with hepatitis C virus (HCV) infection, and overt cryoglobulinemia vasculitis (CryoVas) develops in about 15% of patients. Remission of vasculitis has been associated with viral clearance, but few studies have reported the effectiveness of direct acting antiviral drugs in these patients. We performed open-label, prospective, multi-center study of the effectiveness and tolerance of an all-oral, interferon- and ribavirin-free regimen of sofosbuvir plus daclatasvir in patients with HCV-associated CryoVas...
March 10, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28274850/direct-acting-antiviral-therapy-restores-immune-tolerance-to-patients-with-hepatitis-c-virus-induced-cryoglobulinemia-vasculitis
#5
Cloé Comarmond, Marlène Garrido, Stanislas Pol, Anne-Claire Desbois, Myrto Costopoulos, Magali Le Garff-Tavernier, Si Nafa Si Ahmed, Laurent Alric, Hélène Fontaine, Bertrand Bellier, Anna Maciejewski, Michelle Rosenzwajg, David Klatzmann, Lucile Musset, Thierry Poynard, Patrice Cacoub, David Saadoun
BACKGROUND & AIMS: Interferon-free direct-acting antiviral (DAA) therapies are effective in patients with hepatitis C virus-induced cryoglobulinemia vasculitis (HCV-CV). We analyzed blood samples from patients with HCV-CV before and after DAA therapy to determine mechanisms of these drugs and their effects on cellular immunity. METHODS: We performed a prospective study of 27 consecutive patients with HCV-CV (median age 59 years) treated with DAA therapy (21 patients received sofosbuvir plus ribavirin for 24 weeks, 4 patients received sofosbuvir plus daclatasvir for 12 weeks, and 2 patients received sofosbuvir plus simeprevir for 12 weeks) in Paris, France...
March 5, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28149647/hepatitis-c-and-kidney-disease-a-narrative-review
#6
REVIEW
Rashad S Barsoum, Emad A William, Soha S Khalil
Hepatitis-C (HCV) infection can induce kidney injury, mostly due to formation of immune-complexes and cryoglobulins, and possibly to a direct cytopathic effect. It may cause acute kidney injury (AKI) as a part of systemic vasculitis, and augments the risk of AKI due to other etiologies. It is responsible for mesangiocapillary or membranous glomerulonephritis, and accelerates the progression of chronic kidney disease due to other causes. HCV infection increases cardiovascular and liver-related mortality in patients on regular dialysis...
March 2017: Journal of Advanced Research
https://www.readbyqxmd.com/read/28149646/vasculitic-syndromes-in-hepatitis-c-virus-a-review
#7
REVIEW
Gaafar Ragab, Mohamed A Hussein
Vasculitis is a remarkable presentation of the extrahepatic manifestations of HCV. According to the presence or absence of cryoglobulins it is subdivided into two main types: cryoglobulinemic vasculitis and non cryoglobulinemic vasculitis based on the attribution of vasculitis to serum cryoglobulins as a pathogenic factor. The attribution of cryoglobulinemia to HCV represents a success story in the history of immunology, microbiology, and clinical medicine. HCV can bind to and invade lymphocytes, consequently triggering an immune response through different mechanisms...
March 2017: Journal of Advanced Research
https://www.readbyqxmd.com/read/28101312/cryoglobulin-test-and-cryoglobulinemia-hepatitis-c-virus-related
#8
REVIEW
Francesca Gulli, Stefano Angelo Santini, Cecilia Napodano, Patrizia Bottoni, Krizia Pocino, Gian Ludovico Rapaccini, Umberto Basile
Cryoglobulins are immunoglobulins that precipitate in serum at temperatures below 37°C and resolubilize upon warming. The clinical syndrome of cryoglobulinemia usually includes purpura, weakness, and arthralgia, but the underlying disease may also contribute other symptoms. Blood samples for cryoglobulin are collected, transported, clotted and spun at 37°C, before the precipitate is allowed to form when serum is stored at 4°C in a Wintrobe tube for at least seven days. The most critical and confounding factor affecting the cryoglobulin test is when the preanalytical phase is not fully completed at 37°C...
2017: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/27940588/a-multicentre-study-of-95-biopsy-proven-cases-of-renal-disease-in-primary-sj%C3%A3-gren-s-syndrome
#9
Magali Jasiek, Alexandre Karras, Véronique Le Guern, Evguenia Krastinova, Rafik Mesbah, Stanislas Faguer, Noémie Jourde-Chiche, Anne-Laure Fauchais, Laurent Chiche, Emmanuelle Dernis, Guillaume Moulis, Jean-Baptiste Fraison, Estibaliz Lazaro, Perrine Jullien, Eric Hachulla, Alain Le Quellec, Philippe Rémy, Aurélie Hummel, Nathalie Costedoat-Chalumeau, Pierre Ronco, Philippe Vanhille, Vannary Meas-Yedid, Carole Cordonnier, Sophie Ferlicot, Laurent Daniel, Raphaele Seror, Xavier Mariette, Eric Thervet, Hélène François, Benjamin Terrier
OBJECTIVE: Renal involvement is a rare event during primary SS (pSS). We aimed to describe the clinico-biological and histopathological characteristics of pSS-related nephropathy and its response to treatment. METHODS: We conducted a French nationwide, retrospective, multicentre study including pSS patients fulfilling American-European Consensus Group criteria or enlarged American-European Consensus Group criteria, and with biopsy-proven renal involvement. RESULTS: A total of 95 patients were included (median age 49 years)...
December 10, 2016: Rheumatology
https://www.readbyqxmd.com/read/27938559/-serum-cxcl-10-level-in-chronic-hepatitis-c-patients-with-cryoglobulinemia-and-its-influence-on-antiviral-therapy
#10
X H Fan, Z H Deng, X Y Xu
Objective: To investigate the serum CXCL-10 level in chronic hepatitis C (CHC) patients with cryoglobulinemia and its influence on the effect of antiviral therapy. Methods: A total of 50 CHC patients were enrolled in the study. Cryoprecipitation was used to determine the nature of cryoglobulins in serum before treatment, and ELISA was used to measure the serum CXCL-10 level. The hepatitis C virus (HCV) genotype was detected, and serum HCV RNA level was measured at baseline, 4, 12, and 24 weeks of treatment, the end of treatment, and 24 weeks after treatment...
October 20, 2016: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/27818812/cns-vasculitis-associated-with-waldenstr%C3%A3-m-macroglobulinemia
#11
Tanawan Riangwiwat, Chris Y Wu, Alberto S Santos-Ocampo, Randal J Liu, Aaron M McMurtray, Beau K Nakamoto
Waldenström macroglobulinemia (WM) is an indolent B cell lymphoproliferative disorder with monoclonal IgM secretion. We present a patient with WM who presented with multifocal acute cortical ischemic strokes and was found to have central nervous system (CNS) vasculitis. Workup was negative for cryoglobulins and hyperviscosity syndrome. Immunosuppression with intravenous steroids and cyclophosphamide stabilized the patient's mental status and neurologic deficits. On followup over 7 years, patient gained independence from walking aids and experienced no recurrences of CNS vasculitis...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27799164/how-i-treat-cryoglobulinemia
#12
REVIEW
Eli Muchtar, Hila Magen, Morie A Gertz
Cryoglobulinemia is a distinct entity characterized by the presence of cryoglobulins in the serum. Cryoglobulins differ in their composition, which has an impact on the clinical presentation and the underlying disease that triggers cryoglobulin formation. Cryoglobulinemia is categorized into two main subgroups: type I, which is seen exclusively in clonal hematologic diseases, and type II/III, which is called mixed cryoglobulinemia and is seen in hepatitis C virus infection and systemic diseases such as B-cell lineage hematologic malignancies and connective tissue disorders...
January 19, 2017: Blood
https://www.readbyqxmd.com/read/27725289/virologic-clinical-and-immune-response-outcomes-of-patients-with-hepatitis-c-virus-associated-cryoglobulinemia-treated-with-direct-acting-antivirals
#13
Martín Bonacci, Sabela Lens, María-Carlota Londoño, Zoe Mariño, Maria C Cid, Manuel Ramos-Casals, Jose María Sánchez-Tapias, Xavier Forns, José Hernández-Rodríguez
BACKGROUND & AIMS: Cryoglobulins (circulating immune complexes of polyclonal IgG, monoclonal IgM, and rheumatoid factor) are detected in the circulation of 40% to 60% of patients with chronic hepatitis C virus infection, and cryoglobulinemic vasculitis (CV) is observed in approximately 10% of patients. We aimed to assess the clinical and immune effects of direct-acting antiviral treatment. METHODS: We performed a prospective study of 64 patients with HCV infection with circulating cryoglobulins receiving direct-acting antiviral therapy at a single center in Barcelona, Spain, from January 2014 through April 2016...
October 8, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27723989/-extrahepatic-manifestations-of-hcv-infection
#14
Petr Husa
Extrahepatic manifestations of hepatitis C virus infection (HCV) are very common. The most common of these is mixed cryoglobulinaemia. Anti-HCV antibodies and viral ribonucleic acid, HCV RNA, can be found in the cryoprecipitates, together with the rheumatoid factor. Cryoglobulins consist of a complex of immunoglobulins that in vitro precipitate upon the cooling bellow the human body temperature. Vasculitis is caused by the deposition of such immune complexes in the small blood vessels. A link with the HCV infection is considered to be established with membranoproliferative glomerulonephritis, leukocytoclastic vasculitis, lymphoproliferative disorders (in particular B cell lymphoma), Sjögren and sicca syndrome, lichen planus, porfyria cutanea tarda and diabetes mellitus...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27666584/decline-of-cellular-activation-in-non-b-cells-after-rituximab-treatment-in-hepatitis-c-associated-mixed-cryoglobulinemia-vasculitis
#15
B Emmanuel, N Sidique, X Zhang, B Poonia, M C Sneller, S Kottilil
Mixed cryoglobulinemic vasculitis is associated with the monoclonal expansion of pathognomonic B cells in chronic hepatitis C. Recently, treatment with B-cell depletion, including rituximab, a CD20 monoclonal antibody, has been successful in achieving remission from the active disease. We investigated whether B-cell depletion therapy has an impact on activation of non-B cells in the periphery. Results demonstrated that B-cell depletion therapy is associated with a statistically significant decline in activated T cells, from pretherapy to follow-up while on rituximab therapy: CD4+ CD38+ HLA-DR+ (DR+), CD8+ CD38, CD8+ CD38+ DR+, and CD8+ DR+...
September 25, 2016: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/27610581/influence-of-duration-of-heroin-dependence-on-humoral-immunologic-indicators
#16
Natasha Simonovska, Beti Zafirova-Ivanovska, Aleksandra Babulovska, Zanina Pereska, Irena Jurukov, Liljana Trenchevska-Siljanovska
OBJECTIVE: The incidence of autoantibodies may be associated with the duration of drug use. In this study, we assessed the association between the duration of heroin dependence and various humoral immunologic indicators, including IgA, IgG, IgM, complement component 3, complement component 4, rheumatoid factor, anti-β2-glycoprotein 1 (IgA, IgG, IgM), antinuclear antibody, circulating immune complexes, and cryoglobulins. METHODS: A total of 363 patients with heroin dependence were enrolled in this cross-sectional and prospective study over a 3...
November 2016: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/27605512/interferon-free-antiviral-treatment-in-b-cell-lymphoproliferative-disorders-associated-with-hepatitis-c-virus-infection
#17
Luca Arcaini, Caroline Besson, Marco Frigeni, Hélène Fontaine, Maria Goldaniga, Milvia Casato, Marcella Visentini, Harrys A Torres, Veronique Loustaud-Ratti, Jan Peveling-Oberhag, Paolo Fabris, Roberto Rossotti, Francesco Zaja, Luigi Rigacci, Sara Rattotti, Raffaele Bruno, Michele Merli, Céline Dorival, Laurent Alric, Arnaud Jaccard, Stanislas Pol, Fabrice Carrat, Virginia Valeria Ferretti, Carlo Visco, Olivier Hermine
Regression of hepatitis C virus (HCV)-associated lymphoma with interferon (IFN)-based antiviral treatment supports an etiological link between lymphoma and HCV infection. In addition, a favorable impact of antiviral treatment on overall survival of patients with HCV-related lymphoma has been reported. Data on IFN-free regimens combining direct-acting antivirals (DAAs) in HCV-associated lymphoproliferative disorders are scanty. We analyzed the virological and lymphoproliferative disease response (LDR) of 46 patients with indolent B-cell non-Hodgkin lymphomas (NHLs) or chronic lymphocytic leukemia (CLL) and chronic HCV infection treated with DAAs...
November 24, 2016: Blood
https://www.readbyqxmd.com/read/27519936/cryoglobulinemia-in-a-patient-with-chronic-lymphocytic-leukemia-a-case-report-and-review-of-literature-of-renal-involvement-in-cll
#18
REVIEW
Swaty Arora, Daniel Levitan, Narottam Regmi, Gurinder Sidhu, Raavi Gupta, Anthony D Nicastri, Subodh J Saggi, Albert Braverman
The incidence of glomerulonephritis, as a manifestation of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), has always been considered low. Though renal infiltration is usually detected at post-mortem, it does not often interfere with kidney function [1]. Though immunoglobulin (Ig) levels in most CLL patients are subnormal, small monoclonal Ig peaks are occasionally detected in serum. They were present in a number of reported CLL nephropathy patients, and not all were cryoglobulins; serum and glomerular staining were concordant for Ig type [2,3,4]...
September 2016: Blood Cells, Molecules & Diseases
https://www.readbyqxmd.com/read/27503146/the-kunkel-legacy-and-hepatitis-c-virus-infection
#19
Vincent Agnello
In commemoration of Henry Kunkel's 100th birthday, the effect of his legacy on the investigation of hepatitis C virus is recounted. The delineation of a major cross-idiotype (WA) among patients with essential mixed cryoglobulinemia led to the discovery that HCV was the etiologic agent for this disease. Studies of the cryoglobulins led to the discovery that WA RF reacted specifically with HCV-VLDL like particles that on electronmicroscopy and binding studies appeared to be the virion within a lipid shell. This particle mediates cell entry via LDLr and may serve to avoid the immune response by masking the virion...
November 2016: Clinical Immunology: the Official Journal of the Clinical Immunology Society
https://www.readbyqxmd.com/read/27433994/raynaud-phenomenon-with-severe-ulcers-associated-with-cryoglobulins-in-an-hiv-but-hcv-negative-patient
#20
Ignacio M Santarelli, Diego J Manzella, Diego Costa, Ana A Pisarevsky, Marcelo J Melero
No abstract text is available yet for this article.
September 2016: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
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