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Cryoglobulinemic vasculitis

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https://www.readbyqxmd.com/read/28332476/new-onset-hepatitis-c-virus-associated-glomerulonephritis-following-sustained-virologic-response-with-direct-acting-antiviral-therapy%C3%A2
#1
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/28286108/international-therapeutic-guidelines-for-patients-with-hcv-related-extrahepatic-disorders-a-multidisciplinary-expert-statement
#2
REVIEW
Anna Linda Zignego, Manuel Ramos-Casals, Clodoveo Ferri, David Saadoun, Luca Arcaini, Dario Roccatello, Alessandro Antonelli, Anne Claire Desbois, Cloe Commarmond, Laura Gragnani, Milvia Casato, Peter Lamprecht, Alessandra Mangia, Athanasios G Tzioufas, Zobair M Younossi, Patrice Cacoub
Hepatitis C virus (HCV) is both hepatotrophic and lymphotropic virus that causes liver as well extrahepatic manifestations including cryoglobulinemic vasculitis, the most frequent and studied condition, lymphoma, and neurologic, cardiovascular, endocrine-metabolic or renal diseases. HCV-extrahepatic manifestations (HCV-EHMs) may severely affect the overall prognosis, while viral eradication significantly reduces non-liver related deaths. Different clinical manifestations may coexist in the same patient. Due to the variety of HCV clinical manifestations, a multidisciplinary approach along with appropriate therapeutic strategies are required...
March 7, 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/28224129/erratum-a-rare-case-of-hepatitis-c-associated-cryoglobulinemic-duodenal-vasculitis
#3
Shivali R Berera, Alexandra Gomez, Kevin Dholaria, Leopoldo R Arosemena, Marco A Ladino-Avellaneda, Laura Barisoni, Kalyan R Bhamidimarri
No abstract text is available yet for this article.
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28184378/relapse-of-hcv-genotype-1b-infection-after-sofosbuvir-ledipasvir-treatment-presenting-as-de-novo-cryoglobulinemic-vasculitis
#4
Mohammad Qasim Khan, Alan D Moreno, Nora Joseph, George Kim, Claus J Fimmel
Relapse of hepatitis C virus (HCV) genotype 1 infection after combination therapy with sofosbuvir and ledipasvir is unusual. We report a treatment-naïve, non-cirrhotic patient in whom the relapse of genotype 1b HCV infection was accompanied by de novo cryoglobulinemic vasculitis and glomerulonephritis, requiring hemodialysis for acute renal failure. Sequence analysis revealed several resistance-associated variants in the HCV NS5a gene but not in NS3/4A. The patient's vasculitis was successfully treated with immunosuppression and plasmapheresis, followed by retreatment of HCV with a combination of sofosbuvir, simeprevir, and ribavirin...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28149646/vasculitic-syndromes-in-hepatitis-c-virus-a-review
#5
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/28107583/chronic-hepatitis-c-and-chronic-kidney-disease-advances-limitations-and-unchartered-territories
#6
REVIEW
M Mendizabal, K R Reddy
Over the past few years, treatment options for chronic hepatitis C virus (HCV) infection have evolved dramatically. The current approved interferon-free direct-acting antiviral (DAA) regimens have been shown to be safe and effective with sustained virologic response (SVR) rates of >90% in most patients. Unique issues yet remain such as the challenges in patients with impaired renal function or decompensated cirrhosis. Patients with stages 4-5 chronic kidney disease (CKD) have a higher prevalence of HCV infection compared with the general population...
January 20, 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/27938815/acrally-distributed-dermatoses-vascular-dermatoses-purpura-and-vasculitis
#7
Jana Kazandjieva, Dimitar Antonov, Jivko Kamarashev, Nikolai Tsankov
Purpuric lesions appear in acral distribution in a variety of conditions and often provide clues to the clinical diagnosis. Purpuric means "hemorrhagic"-that is, the lesions do not blanch from pressure. This review focuses on dermatoses that produce hemorrhagic lesions in acral distribution from the large groups of the vasculitic diseases and their mimics. Cutaneous small vessel vasculitis is confined to the skin, involves mainly postcapillary venules, and has the hallmark manifestation of palpable purpura...
January 2017: Clinics in Dermatology
https://www.readbyqxmd.com/read/27870771/multiorgan-failure-from-cryoglobulinemic-vasculitis-following-intravenous-immunoglobulin-replacement-therapy
#8
Paul Oykhman, Marlene A Hamilton, Stephen L Aaron
No abstract text is available yet for this article.
December 2016: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/27807586/a-rare-case-of-hepatitis-c-associated-cryoglobulinemic-duodenal-vasculitis
#9
Shivali R Berera, Alexandra Gomez, Kevin Dholaria, Leopoldo R Arosemena, Marco A Ladino-Avellaneda, Laura Barisoni, Kalyan R Bhamidimarri
Intestinal involvement of cryoglobulinemia is an uncommon manifestation and marker of severe vasculitis. We describe the case of a woman admitted to our service for management of acute renal failure and progressive gastrointestinal symptoms after initiating hepatitis C virus treatment with ribavirin and sofosbuvir 4 weeks prior. With an undetectable hepatitis C viral load and persistent symptoms despite hepatitis C virus therapy cessation, an upper endoscopy revealed duodenal sloughing, erythema, and bleeding, sparking suspicion for recurrence of cryoglobulinemic vasculitis...
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/27791307/pediatric-cryoglobulinemic-vasculitis-successfully-managed-with-rituximab
#10
C Giménez-Roca, E Iglesias, M A Vicente, R Bou, J Calzada-Hernández, C Prat, M García, J Antón
No abstract text is available yet for this article.
October 28, 2016: Dermatologic Therapy
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
#11
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/27666584/decline-of-cellular-activation-in-non-b-cells-after-rituximab-treatment-in-hepatitis-c-associated-mixed-cryoglobulinemia-vasculitis
#12
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/27662570/infections-and-vasculitis
#13
Konstantinos Thomas, Dimitrios Vassilopoulos
PURPOSE OF REVIEW: To review recent evidence for infection rates in patients with systemic vasculitides, the role of specific infectious agents in the pathogenesis of vasculitis and recent breakthroughs in the treatment of virus-associated vasculitides. RECENT FINDINGS: In well designed recent studies, infections were found to be common during the first 6-12 months in patients with anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitides (AAV) and giant cell arteritis (GCA) and to contribute significantly to increased mortality during this period...
January 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/27458597/rituximab-for-sj%C3%A3-gren-syndrome-associated-type-ii-mixed-cryoglobulinemic-cerebral-vasculitis
#14
Bertrand Lioger, Nicole Ferreira-Maldent, Jean Philippe Cottier, Séverine Debiais, Emmanuel Gyan, François Maillot
No abstract text is available yet for this article.
August 2016: Neurology® Neuroimmunology & Neuroinflammation
https://www.readbyqxmd.com/read/27267327/the-correlation-between-antiphospholipid-syndrome-and-cryoglobulinemia-case-series-of-4-patients-and-review-of-the-literature
#15
Shiber Shachaf, Molad Yair
BACKGROUND: Cryoglobulinemia is an immune-complex-mediated small vessel vasculitis that classically involves the skin, kidneys and peripheral nerves. Antiphospholipid syndrome (APS) is an autoimmune hypercoagulable disorder which causes blood vessel thrombosis. It can present as a multi-organ microthrombotic disorder which is called catastrophic APS. OBJECTIVE: In this case series we aim to describe the diagnostic and management challenges that arise when these two severe disorders simultaneously present in the same patient...
January 2016: Revista Brasileira de Reumatologia
https://www.readbyqxmd.com/read/27222744/antiviral-treatment-prioritization-in-hcv-infected-patients-with-extrahepatic-manifestations-an-egyptian-perspective
#16
Hussein El-Fishawy, Gamal Saadi, May Hassaballa, Mohamed Hussein, Wahid Doss, Gaafar Ragab, Rashad Barsoum
Egypt, the single country with highest incidence of HCV infection in the world, has embarked on a government-sponsored mass treatment program using several combinations of DAAs. Recognizing the importance of extrahepatic manifestations, independently of the hepatic, a subcommittee was assigned to develop national guidelines for respective prioritizing indications and protocols. It evaluated the benefit of treating patients with different extrahepatic manifestations, and reviewed relevant clinical trials and guidelines concerning DAA combinations available in Egypt...
May 2016: Journal of Advanced Research
https://www.readbyqxmd.com/read/27190872/an-unusual-case-of-hcv-negative-cryoglobulinemia-presenting-as-symmetrical-peripheral-gangrene
#17
Siba Prasad Dalai, Lalit Kumar Meher, Samir Kumar Behera, Sachidananda Nayak, Sujit Kumar Tripathy
Cryoglobulins are monoclonal or polyclonal immunoglobulins that undergo reversible precipitation at low temperatures. Cryoglobulinemia is associated with HCV infection in more than 90% cases, the remaining 10% being called as Essential Cryoglobulinemia which is generally associated with a severe course and suboptimal response to conventional therapies. As the digital vessels are more prone to colder temperatures, hyperviscosity in those vessels can initiate local thrombosis and may manifest as ischemic ulceration and gangrene...
April 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27181547/igg4-related-sialoadenitis-with-a-skin-lesion-and-multiple-mononeuropathies-suggesting-coexistent-cryoglobulinemic-vasculitis
#18
Mari Kamiya, Peter Y Shane, Makoto Soejima, Shuji Tohda, Nobuyuki Miyasaka, Hitoshi Kohsaka
A 68-year-old man was admitted because of weakness of the left leg, dysesthesiae of the extremities and bilateral lower extremity purpura. A neurological examination showed mononeuritis multiplex with laboratory evidence of hypocomplementemia, cryoglobulinemia and leukocytoclastic vasculitis in the biopsy of a skin specimen. The patient also exhibited bilateral submandibular gland swelling, elevated serum IgG4 levels and infiltration of a large number of IgG4-positive plasma cells in the submandibular glands...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27118389/management-of-small-vessel-vasculitides
#19
REVIEW
Giuseppe Lopalco, Donato Rigante, Vincenzo Venerito, Giacomo Emmi, Maria Grazia Anelli, Giovanni Lapadula, Florenzo Iannone, Luca Cantarini
Inflammation mediated by cells of the immune system and necrosis are the most striking features observed at the histologic level in patients with vasculitides, clinical entities classified according to pathologic findings involving different organs, to etiology, or to size of vessels involved. Small vessel vasculitides (SVV) are a peculiar group of systemic disorders electively involving small intraparenchymal arteries, arterioles, capillaries, or venules and leading to different levels of vascular obstruction, tissue ischemia and risk of infarction; they can be divided into anti-neutrophil cytoplasmic antibody-associated vasculitides and immune complex vasculitides...
June 2016: Current Rheumatology Reports
https://www.readbyqxmd.com/read/27106525/hepatitis-b-virus-related-cryoglobulinemic-vasculitis-a-multicentre-open-label-study-from-the-gruppo-italiano-di-studio-delle-crioglobulinemie-gisc
#20
Cesare Mazzaro, Luigino Dal Maso, Teresa Urraro, Endri Mauro, Laura Castelnovo, Pietro Casarin, Giuseppe Monti, Valter Gattei, Anna Linda Zignego, Gabriele Pozzato
BACKGROUND: Cryoglobulinemic vasculitis (CV) related to Hepatitis-B Virus (HBV) is rare and its treatment is ill-defined. AIMS: To describe clinical and treatment characteristics of HBV-related CV patients. In addition, the efficacy of treatment with antiviral agent nucleotide (NUC), including Entecavir, Adefovir, and Lamivudine, was explored. METHODS: In four Italian centres, 17 HBV-positive CV patients (median age 56 years, range 45-70) were enrolled...
July 2016: Digestive and Liver Disease
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