4,834 results match your criteria Cryoglobulinemia


Management of Hematologic Adverse Events Associated With Immune Checkpoint Inhibitors.

J Adv Pract Oncol 2021 May 1;12(4):392-404. Epub 2021 May 1.

Fox Chase Cancer Center, Philadelphia, Pennsylvania.

Immune checkpoint inhibitors target suppressor receptors, including cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4), programmed cell death protein 1 (PD-1), and programmed cell death ligand 1 (PD-L1). The activated T cells are not antigen specific; therefore, the blockade of the immune checkpoint may result in the development of autoimmune adverse events. The most common immune-related adverse events (irAEs) are rash, colitis, and endocrinopathies. Read More

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Challenging the Association of Hepatitis C and Pyoderma Gangrenosum.

Br J Dermatol 2021 Jun 9. Epub 2021 Jun 9.

Faculty of Medicine, University of Toronto, Toronto, Canada.

Pyoderma Gangrenosum (PG) is most often associated with Inflammatory Bowel Disease (IBD), inflammatory arthritis, hematologic dyscrasias (particularly IgA), and malignancies. In order to rule out common mimickers, histology of an active ulcer edge serves as a major criterion in two widely used diagnostic criteria. A less frequently described PG association is viral hepatitis, specifically Hepatitis C Virus (HCV). Read More

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Hepatitis B Virus-Related Cryoglobulinemic Vasculitis: Review of the Literature and Long-Term Follow-Up Analysis of 18 Patients Treated with Nucleos(t)ide Analogues from the Italian Study Group of Cryoglobulinemia (GISC).

Viruses 2021 May 30;13(6). Epub 2021 May 30.

Rheumatology Clinic, Department of Medicine (DAME), ASUFC, University of Udine, 33100 Udine, Italy.

Hepatitis B virus (HBV) chronic infection causes progressive liver damage, although about 20% of patients develop extrahepatic manifestations such as cryoglobulinemic vasculitis (CV). Clinical manifestations range from mild to moderate (purpura, asthenia, arthralgia) to severe (leg ulcers, peripheral neuropathy, glomerulonephritis, non-Hodgkin lymphoma). A comprehensive review of therapeutic options for HBV-related CV is lacking. Read More

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Progress in hepatitis C virus management in chronic kidney disease.

Curr Opin Nephrol Hypertens 2021 May 28. Epub 2021 May 28.

Renal Division and Transplant Center, Massachusetts General Hospital, Harvard Medical School Renal Section, Department of Medicine, Boston University School of Medicine Division of Nephrology, Department of Medicine, Tufts University School of Medicine, Boston Massachusetts, USA.

Purpose Of Review: The current review highlights advances in the use of direct-acting antiviral (DAA) agents in the treatment of hepatitis C virus (HCV) in chronic kidney disease (CKD) stages G4-5, end-stage renal disease, and kidney transplantation. The use of DAA to facilitate kidney transplantation of HCV negative recipients with kidneys from HCV-infected donors and in the management of HCV-related cryoglobulinemia are also reviewed.

Recent Findings: DAA treatment results in rates of viral clearance (sustained virological response or SVR) of 90-100% in all studied CKD populations, comparable to SVR rates in the general population. Read More

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The enigma of complement activation in mixed cryoglobulinemia.

Dig Liver Dis 2021 May 26. Epub 2021 May 26.

Department of Medicine (Rheumatology, Allergy and Immunology), Stony Brook University Renaissance School of Medicine, United States. Electronic address:

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Dynamics of serum α-fetoprotein in viral hepatitis C without hepatocellular carcinoma.

Exp Ther Med 2021 Jul 12;22(1):749. Epub 2021 May 12.

Department of Internal Medicine II, Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.

Viral hepatitis C represents a significant liver pathology worldwide, with a detrimental impact on national health systems. The present study aimed to correlate the levels of serum α-fetoprotein (AFP) with prognostic tools such as Fibroscan, the presence of mixed cryoglobulinemia, and various demographic and standard biochemical markers, in patients with chronic hepatitis C, unrelated to hepatocellular carcinoma (HCC). A clinical study was designed considering three study groups: Hepatitis C virus (HCV) group including 35 patients with chronic hepatitis C and detectible viral load; sustained viral response (SVR) group including 20 HCV patients without detectable virus load 12 weeks after therapy cessation; a control group represented by 37 healthy volunteers. Read More

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A biomarker for lymphoma development in Sjogren's syndrome: Salivary gland focus score.

J Autoimmun 2021 Jul 21;121:102648. Epub 2021 May 21.

Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. Electronic address:

The aim of this study is to explore the role of labial minor salivary gland (LMSG) focus score (FS) in stratifying Sjögren's Syndrome (SS) patients, lymphoma development prediction and to facilitate early lymphoma diagnosis. Ιn an integrated cohort of 1997 patients, 618 patients with FS ≥ 1 and at least one-year elapsing time interval from SS diagnosis to lymphoma diagnosis or last follow up were identified. Clinical, laboratory and serological features were recorded. Read More

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Immune disorders and rheumatologic manifestations of viral hepatitis.

World J Gastroenterol 2021 May;27(18):2073-2089

Department of Internal Medicine, Gastroenterology and Hepatology, Sechenov University, Moscow 119435, Russia.

Infection with hepatotropic viruses is not limited to the liver and can lead to the development of various immunological disorders (the formation of cryoglobulins, rheumatoid factor, antinuclear antibodies, autoantibodies specific for autoimmune hepatitis and primary biliary cholangitis, and others), which can manifest as glomerulonephritis, arthritis, uveitis, vasculitis (cryoglobulinemic vasculitis, polyarteritis nodosa, Henoch-Schonlein purpura, isolated cutaneous necrotizing vasculitis), and other rheumatologic disorders, and be a trigger for the subsequent development of autoimmune hepatitis and primary biliary cholangitis. A further study of the association between autoimmune liver diseases and hepatotropic virus infection would be useful to assess the results of treatment of these associated diseases with antiviral drugs. The relationship of these immune disorders and their manifestations with hepatotropic viruses is best studied for chronic hepatitis B and C. Read More

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Pheochromocytoma presenting as an authentic small vessel vasculitis and complicated with pulmonary embolism: An original presentation.

Ann Cardiol Angeiol (Paris) 2021 Jun 4;70(3):168-170. Epub 2021 May 4.

Service de médecine interne, Hôpital Mongi Slim La Marsa, Tunis, Tunisia.

Diagnosis of pheochromocytoma can be simple when classic manifestations are present. It can also be challenging and complicated in some cases because of its wide array of faces and presentations. We present a case of a 30-year-old female patient who came with acute respiratory distress, chest pain, hemoptysis, asthenia, anorexia, weight loss of 20kg, and paresthesia in her lower limbs. Read More

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Thymic Carcinoma with Multiple Paraneoplastic Disorders.

Am J Med Sci 2021 May 4. Epub 2021 May 4.

2(nd) Academic Department of Internal Medicine, Medical School, National & Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece. Electronic address:

Thymic neoplasms are rare and may run an indolent course. Among them, thymic epithelial carcinoma is exceptional as it may be presented with extensive local invasion and distant metastases. There is a wide spectrum of autoimmune/paraneoplastic syndromes associated with thymic tumors including autoimmune diseases, some of which may precede the diagnosis of thymoma. Read More

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Cryocrystalglobulinemia-An Uncommon Cutaneous Presentation of Multiple Myeloma and Novel Finding of Transepidermal Elimination of Crystals.

Am J Dermatopathol 2021 May 5. Epub 2021 May 5.

Department of Dermatology, National Skin Centre, Singapore, Singapore.

Abstract: Cryocrystalglobulinemia (CCG) is a rare subset of type 1 cryoglobulinemia that is classically associated with an underlying paraproteinemia. The cryocrystalglobulins are characterized by extracellular crystals, which are eosinophilic, periodic acid-Schiff positive, and exhibit nonbirefringence under polarized light. This archetypal appearance renders CCG readily diagnosable histologically. Read More

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Extremity Gangrene Caused by HBV-Related Cryoglobulinemia Vasculitis in a Patient with Diabetes - A Case Report.

J Inflamm Res 2021 28;14:1661-1666. Epub 2021 Apr 28.

Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.

We presented a case of hepatitis B virus (HBV)-related type III cryoglobulinemia vasculitis (CryoVas) characterized by extremity gangrene in a patient with diabetes. The 60-year-old female had a 10-year history of poorly controlled type 2 diabetes mellitus. She complained of sudden onset pain and swelling of toes which quickly progressed to gangrene, with fingers becoming pain and dark violet. Read More

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Provisional recommendations for SARS-CoV-2 vaccination in patients with cryoglobulinaemic vasculitis.

Clin Exp Rheumatol 2021 Mar-Apr;39 Suppl 129(2):149-154. Epub 2021 Apr 30.

Department of Clinical and Biomedical Sciences "Luigi Sacco", University of Milano, III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milano, Italy.

People with cryoglobulinaemic vasculitis (CV) have an increased risk of infections, attributed to different causes: impairment of the immune system due to the disease itself, comorbidities, and immunosuppressive therapy. Therefore, these patients may be at high risk for a more severe course of COVID-19, including hospitalisation and death. Concerns about efficacy, immunogenicity and safety of vaccines, as well as doubts, not yet fully clarified in patients with systemic autoimmune diseases, represent other important factors for a low vaccination rate in people with (CV). Read More

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Immunoglobulin and complement-mediated glomerular diseases with an MPGN pattern of injury: Unmasking the diagnosis of lupus in a patient with hepatitis A infection.

Clin Case Rep 2021 Apr 16;9(4):2083-2087. Epub 2021 Feb 16.

Richard Bright Renal Service North Bristol National Health Service Trust Bristol UK.

In cases with a broad differential or atypical features, it is important to continually review the original diagnosis. Diagnosing SLE can be challenging due to its multisystem presentations; a multidisciplinary approach is beneficial. Read More

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Mortality in patients with primary Sjögren's syndrome: A systematic review and meta-analysis.

Rheumatology (Oxford) 2021 Apr 20. Epub 2021 Apr 20.

Department of Rheumatology and Clinical Immunology, Peking University First Hospital, Beijing 100034, China.

Objective: It remains debated whether patients with primary Sjögren's syndrome (pSS) are at greater risk of mortality. We aimed to determine the magnitude of all-cause mortality risk in patients with pSS compared with the general population through a systematic review and meta-analysis.

Methods: We searched Pubmed, EMBASE and Cochrane Library for studies published from inception to October 2020. Read More

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In vitro diagnostics for the medical dermatologist. Part II: Hypercoagulability tests.

J Am Acad Dermatol 2021 Apr 20. Epub 2021 Apr 20.

Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio. Electronic address:

The skin often provides initial clues of hypercoagulability with features such as livedo reticularis, livedo racemosa, retiform purpura, necrosis, and ulcerations. Because these cutaneous manifestations are nonspecific, laboratory testing is often needed to evaluate for underlying causes of hypercoagulability. Importantly, these disorders are reported to be the most common mimicker, resulting in an erroneous diagnosis of pyoderma gangrenosum. Read More

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Peripheral Nervous System Involvement in Sjögren's Syndrome: Analysis of a Cohort From the Italian Research Group on Sjögren's Syndrome.

Front Immunol 2021 24;12:615656. Epub 2021 Mar 24.

Rheumatology Unit, Department of Medicine, University of Perugia, Perugia, Italy.

Purpose: The prevalence of peripheral nervous system (PNS) involvement in primary Sjögren's syndrome (pSS) has been reported to range from 2% to over 50%. Bias in study designs, including low number of patients and unclearly defined rheumatological and neurological diagnosis could explain such variability. Consequently, the exact depiction of PNS involvement in pSS is still lacking. Read More

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Incidental case of primary renal lymphoma (PRL) in a patient with chronic hepatitis C infection. Report of a rare case.

Rom J Morphol Embryol 2020 Jul-Sep;61(3):929-934

Department of Internal Medicine, Sf. Ioan Emergency Clinical Hospital, Bucharest, Romania; Department of Radiology, Grigore T. Popa University of Medicine and Pharmacy, Iaşi, Romania;

Chronic viral hepatitis C (CHC) is a global health problem, being responsible for about 399 000 deaths worldwide, mostly from cirrhosis and hepatocellular carcinoma. Virus C infection has well known hepatic manifestations - cirrhosis and liver cancer - but the extrahepatic ones are responsible for up to 75% of morbidity in these patients. The well-known hepatitis C virus (HCV) lymphotropism is probably linked with the most frequent extrahepatic manifestations, mixed cryoglobulinemia and B-cell non-Hodgkin's lymphoma (BCNHL). Read More

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Genetic Association of Hepatitis C-Related Mixed Cryoglobulinemia: A 10-Year Prospective Study of Asians Treated with Antivirals.

Viruses 2021 03 11;13(3). Epub 2021 Mar 11.

Institute of Biomedical Sciences, Academia Sinica, Taipei 115024, Taiwan.

Genetic profiles of hepatitis C virus (HCV)-associated mixed cryoglobulinemia (MC) in Asians remain elusive. A 10-year prospective cohort study was conducted with 1043 consecutive HCV Ab-positive Taiwanese surveyed with 13 single nucleotide polymorphisms (SNPs). Of 1043, 589 (56. Read More

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Impact of direct acting antivirals on hepatitis c virus-related cryoglobulinemic syndrome.

Minerva Gastroenterol (Torino) 2021 Apr 1. Epub 2021 Apr 1.

MASVE Interdepartmental Hepatology Center, Department of Experimental and clinical Medicine, Center for Research and Innovation CRIAMASVE, University of Florence, Firenze, Italy.

Introduction: Mixed cryoglobulinemia (MC) is a B-cell lymphoproliferative disorder largely attributable to HCV infection. MC clinical manifestations are determined by systemic vasculitis of low/medium sized vessels (mixed cryoglobulinemia syndrome or cryoglobulinemic vasculitis and CV) caused by the deposition of cryoglobulins in blood vessels.

Evidence Acquisition: A systematic review was performed via the Medline and Scopus databases to evaluate studies concerning CV treatment with new direct antiviral agents (DAAs) and their effect on the syndrome. Read More

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Glomerulonephritis in AKI: From Pathogenesis to Therapeutic Intervention.

Front Med (Lausanne) 2020 2;7:582272. Epub 2021 Mar 2.

Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy.

Acute kidney injury (AKI) is increasingly emerging as a global emergency. Sepsis, major surgery, and nephrotoxic drugs are the main causes of AKI in hospitalized patients. However, glomerulonephritis accounts for about 10% of AKI episodes in adults, mainly related to rapidly progressive glomerulonephritis resulting from granulomatous polyangiitis (GPA, Wegener granulomatosis), microscopic polyangiitis (MPA), and anti-glomerular basement membrane (GBM) disease. Read More

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Obinutuzumab Rescue in Rituximab Resistant Mixed Cryoglobulinemia.

Kidney Int Rep 2021 Mar 5;6(3):865-866. Epub 2021 Feb 5.

Division of Nephrology, Hôpital du Sacré-Cœur de Montréal, Quebec, Canada.

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Extrahepatic Manifestations of Chronic HCV Infection.

N Engl J Med 2021 03;384(11):1038-1052

From the Department of Internal Medicine and Clinical Immunology, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Centre de Référence des Maladies Auto-Immunes Systémiques Rares and Centre de Référence des Maladies Auto-Inflammatoires et de l'Amylose Inflammatoire, Institut National de la Santé et de la Recherche Médicale UMR S 959, Centre National de la Recherche Scientifique FRE3632, and the Inflammation-Immunopathology-Biotherapy Department, Sorbonne Université - all in Paris.

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Renal Involvement and HBV Infection Are Common in Chinese Patients With Cryoglobulinemia.

Front Immunol 2021 25;12:580271. Epub 2021 Feb 25.

Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing, China.

This study aimed to describe the main characteristics of Chinese patients with cryoglobulinemia, especially the characteristics of patients with different causes of cryoglobulinemia. Eighty inpatients diagnosed with cryoglobulinemia from different wards in Peking Union Medical College Hospital were included in this study. Demographic, clinical, biological, and renal pathological data were collected. Read More

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February 2021

Spectrum of Kidney Diseases in Patients With Hepatitis C Virus Infection.

Am J Clin Pathol 2021 Feb 24. Epub 2021 Feb 24.

Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, TN, USA.

Objectives: To study the pathologic spectrum of kidney diseases in patients with hepatitis C virus infection (HCV+).

Methods: Native kidney biopsy specimens in HCV+ patients were reviewed.

Results: A total of 9,836 native kidney biopsy specimens were evaluated from January 2007 to December 2016, of which 273 (2. Read More

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February 2021

Direct-acting antiviral therapy improves kidney survival in hepatitis C virus-associated cryoglobulinaemia: the RENALCRYOGLOBULINEMIC study.

Clin Kidney J 2021 Feb 25;14(2):586-592. Epub 2020 Jan 25.

Department of Nephrology, University Hospital Gregorio Marañón, Madrid, Spain.

Background: Direct-acting antiviral agents (DAAs) have shown high rates of sustained virological response in chronic hepatitis C virus (HCV) infection. However, the influence of DAAs on the course of kidney involvement in HCV-associated mixed cryoglobulinaemia (HCV-MC) has been little studied. The aim of this study was to analyse the effects of antiviral treatment on kidney prognosis and evolution in patients diagnosed with HCV-MC. Read More

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February 2021

Cryoglobulinemic glomerulonephritis with underlying occult HBV infection and Waldenström macroglobulinemia: A case report.

Medicine (Baltimore) 2021 Feb;100(7):e24792

Division of Nephrology, Department of Internal Medicine, National Cheng Kung University Hospital.

Introduction: Occult hepatitis B virus (HBV) infection, defined as negative hepatitis B surface antigen (HBsAg) but detectable HBV DNA in serum and liver tissue, has very rarely been described in cryoglobulinemia (CG) patients. This case report sheds light on the possible link between occult HBV infection and CG.

Patient Concerns: A 76-year-old man presented with rapidly deteriorating renal function within 1 year. Read More

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February 2021

Hepatitis C-related membranoproliferative glomerulonephritis in the era of direct antiviral agents.

J Bras Nefrol 2021 Feb 12. Epub 2021 Feb 12.

Cairo University, Faculty of Medicine, Pathology Department, Cairo, Egypt.

Membranoproliferative glomerulonephritis (MPGN) is the most typical Hepatitis C virus (HCV)-associated glomerulopathy, and the available data about the utilization of direct-acting antivirals (DAA) in HCV-associated glomerulonephritis is inadequate. We evaluated the renal and viral response in two cases of HCV-related MPGN; the first caused by cryoglobulinemia while the second was cryoglobulin-negative. Both patients received immunosuppression besides DAA in different regimens. Read More

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February 2021