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Cryoglobulinemic vasculitis

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https://www.readbyqxmd.com/read/28631698/-hepatitis-c-virus-associated-cryoglobulinemic-vasculitis-a-20-year-experience-with-treatment
#1
T M Ignatova, L V Kozlovskaya, N B Gordovskaya, O A Chernova, S Yu Milovanova, P I Novikov, T P Nekrasova, T V Beketova, N A Mukhin
AIM: To summarize the experience of a multidisciplinary therapy hospital in treating patients with hepatitis C virus (HCV)-associated cryoglobulinemic vasculitis (CV). SUBJECTS AND METHODS: Seventy-two patients (mean age, 49.4±10.3 years) with HCV-associated CV were examined and followed up for an average period of 2.8±3.6 years. The efficiency of traditional (corticosteroids ± cyclophosphamide) and selective (rituximab) immunosuppressive therapy (IST) was estimated in 31 and 15 observations, respectively, and that of antiviral therapy (AVT) in 25...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28584732/treatment-of-hcv-in-renal-disease-subtle-management-considerations-in-the-era-of-direct-acting-antivirals
#2
Yuval A Patel, Andrew J Muir
Chronic hepatitis C virus (HCV) infection is burdensome in patients with chronic kidney disease and contributes to substantial liver-related and all-cause morbidity and mortality. HCV infection itself may cause kidney dysfunction, as exemplified through mixed cryoglobulinemic vasculitis. HCV is more prevalent in patients with significant kidney disease compared to the general population, and recent reports have shown inadvertent HCV transmission in U.S. hemodialysis centers. Further, HCV has been demonstrated to accelerate kidney dysfunction and is associated with worse clinical outcomes in patients with kidney disease...
December 2016: Current Hepatology Reports
https://www.readbyqxmd.com/read/28555254/successful-antifungal-combination-therapy-and-surgical-approach-for-aspergillus-fumigatus-suppurative-thyroiditis-associated-with-thyrotoxicosis-and-review-of-published-reports
#3
S Nicolè, M Lanzafame, A Cazzadori, M Vincenzi, F Mangani, C Colato, G El Dalati, P Brazzarola, E Concia
In immunocompromised patients, Aspergillus infections are important causes of morbidity and mortality. We describe a patient with cryoglobulinemic vasculitis who developed disseminated invasive aspergillosis with thyrotoxicosis caused by Aspergillus fumigatus. The diagnosis was based upon radiological, microbiological and pathological findings. The patient was treated successfully with voriconazole and caspofungin treatment followed by total thyroidectomy. We provide an overview of published reports on Aspergillus thyroiditis with an emphasis on therapeutic approaches...
May 29, 2017: Mycopathologia
https://www.readbyqxmd.com/read/28535620/a-case-of-false-positive-troponin-i-in-a-patient-affected-by-cryoglobulinemic-vasculitis
#4
M Bellan, M Pirisi, G Bellomo, P P Sainaghi
Troponin I (TnI) false positive results have been reported in patients affected by immune disorders. We report the case of a 74-year-old woman affected by cryoglobulinemic vasculitis, admitted to the Emergency Room because of a lipotimic episode. A marked elevation of TnI plasma concentration was confirmed in multiple determinations, despite the absence of symptoms or electrocardiogram findings suggesting myocardial infarction. TnI plasma concentration was reported normal after re-testing with a different commercial kit...
May 22, 2017: Reumatismo
https://www.readbyqxmd.com/read/28528615/chronic-tender-ulcers-on-the-calf-and-both-forearms
#5
Michael C Cameron, Mitsuya Katayama, Nishit S Patel, Philip D Shenefelt, Charurut Somboonwit
An elderly woman presented with a 3-month history of nonhealing, tender ulcers involving the right calf and both forearms. She denied any history of similar lesions or trauma. Two trials of oral antibiotics had led to no improvement. Her medical history was significant for rheumatoid arthritis treated with methotrexate, hydroxychloroquine, and prednisone. A review of clinical manifestations was otherwise negative for disease. Physical examination of the patient's right calf revealed two punched-out ulcers with central necrotic black eschars, underlying retiform purpuric pattern, and mild fibrinopurulent drainage (Figure 1)...
2017: Skinmed
https://www.readbyqxmd.com/read/28514410/-cryoglobulinemic-vasculitis-in-chronic-hepatitis-c-genetic-aspects
#6
M G Artemova, D T Abdurakhmanov
Cryoglobulinemia (CG) is detected in more than 50% of patients with chronic hepatitis C (CHC); however, only 15-25% of them develop cryoglobulinemic vasculitis (CV) that is a systemic vasculitis due to the formation of immune deposits, which affects small (less than medium-sized) vessels and which is frequently fatal for the patient. The causes of CG only in some patients with CHC and the pathogenesis of CV remain unstudied; however, the accumulated data allow one to identify the special contribution of the patient's genetic factors to the development of the disease...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28509128/a-case-of-rapid-amelioration-of-hepatitis-c-virus-associated-cryoglobulinemic-membranoproliferative-glomerulonephritis-treated-by-interferon-free-directly-acting-antivirals-for-hcv-in-the-absence-of-immunosuppressant
#7
Fumiaki Obata, Taichi Murakami, Junko Miyagi, Sayo Ueda, Taizo Inagaki, Masanori Minato, Hiroyuki Ono, Kenji Nishimura, Eriko Shibata, Masanori Tamaki, Sakiya Yoshimoto, Fumi Kishi, Seiji Kishi, Motokazu Matsuura, Kojiro Nagai, Hideharu Abe, Toshio Doi
Mixed cryoglobulinemic syndrome, which is a systemic vasculitis characterized by the immune complex deposition in small- and medium-sized arteries and most often due to chronic hepatitis C virus (HCV) infection, sometimes clinically manifests as refractory glomerulonephritis or nephritic syndrome. Patients with mixed cryoglobulinemic nephropathy who have a rapidly progressive glomerulonephritis should receive immunosuppressive therapy. After disease stabilization, patients should receive concurrent therapy for the underlying HCV infection...
May 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28507447/managing-refractory-cryoglobulinemic-vasculitis-challenges-and-solutions
#8
REVIEW
Predrag Ostojic, Ivan R Jeremic
Cryoglobulinemia is thought to be a rare condition. It may be an isolated disorder or secondary to a particular disease. According to immunoglobulin composition, cryoglobulinemia is classified into three types. In mixed cryoglobulinemia (types II and III), vascular deposition of cryoglobulin-containing immune complexes and complement may induce a clinical syndrome, characterized by systemic vasculitis and inflammation - cryoglobulinemic vasculitis (CryoVas). Most common clinical manifestations in CryoVas are skin lesions (orthostatic purpura and ulcers), weakness, peripheral neuropathy, Raynaud's phenomenon, sicca syndrome, membranoproliferative glomerulonephritis, and arthralgia and seldom arthritis...
2017: Journal of Inflammation Research
https://www.readbyqxmd.com/read/28454112/the-challenge-of-treating-hepatitis-c-virus-associated-cryoglobulinemic-vasculitis-in-the-era-of-anti-cd20-monoclonal-antibodies-and-direct-antiviral-agents
#9
REVIEW
Dario Roccatello, Savino Sciascia, Daniela Rossi, Laura Solfietti, Roberta Fenoglio, Elisa Menegatti, Simone Baldovino
Mixed cryoglobulinemia syndrome (MC) is a systemic vasculitis involving kidneys, joints, skin, and peripheral nerves. While many autoimmune, lymphoproliferative, and neoplastic disorders have been associated with this disorder, hepatitis C virus (HCV) is known to be the etiologic agent in the majority of patients. Therefore, clinical research has focused on anti-viral drugs and, more recently, on the new, highly potent Direct-acting Antiviral Agents (DAAs). These drugs assure sustained virologic response (SVR) rates >90%...
June 20, 2017: Oncotarget
https://www.readbyqxmd.com/read/28332476/new-onset-hepatitis-c-virus-associated-glomerulonephritis-following-sustained-virologic-response-with-direct-acting-antiviral-therapy%C3%A2
#10
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...
May 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28286108/international-therapeutic-guidelines-for-patients-with-hcv-related-extrahepatic-disorders-a-multidisciplinary-expert-statement
#11
REVIEW
Anna Linda Zignego, Manuel Ramos-Casals, Clodoveo Ferri, David Saadoun, Luca Arcaini, Dario Roccatello, Alessandro Antonelli, Anne Claire Desbois, Cloe Comarmond, 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
#12
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
#13
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
#14
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
#15
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...
June 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/27938815/acrally-distributed-dermatoses-vascular-dermatoses-purpura-and-vasculitis
#16
REVIEW
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
#17
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
#18
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
#19
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
#20
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...
April 2017: Clinical Gastroenterology and Hepatology
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